METHADONE AND ITS RISKS

Administered under the supervision of a knowledgeable physician,
methadone is a powerfully effective drug that can help alleviate
chronic pain or wean addicts away from their dependence on illegal
narcotics. Used improperly, methadone can be as lethal as an overdose
of heroin or cocaine. A series on methadone beginning in today's Post
describes how the drug's increasing popularity as a legally
prescribed painkiller -- and its illicit use as a street drug -- has
brought a tandem rise in unintentional overdose deaths.

Nationally, it's estimated that methadone overdose deaths have risen
almost 400 percent since 1999. That year, overdoses accounted for 623
deaths, according to health experts.

By 2003, the number of overdose deaths had rocketed to 2,452. In
Rowan County, methadone has been implicated in nearly half the
unintentional overdose deaths registered between 2003 and 2005.
Considering the alarming list of potential side effects that
accompanies almost any prescription medication these days, perhaps it
should come as no surprise that a powerful synthetic opiate such as
methadone could pose catastrophic consequences if taken in doses
beyond those prescribed in a clinical setting.

What makes methadone especially problematic, however, is that it is
highly addictive, although it doesn't offer users a typical "high,"
and it can stay in the body for more than two days after its
analgesic effect has subsided.

Whether it's an abuser popping pills in search of a non-existent high
or a patient seeking relief from pain by going beyond the prescribed
amount, the overdose danger is the same: Methadone can quickly build
up to toxic levels, an effect exacerbated if someone is taking other
drugs at the same time. By the time a patient recognizes signs of
trouble such as irregular or shallow breathing, sleepiness, dizziness
or confusion, he or she may not be able to get help.

For drug abusers who buy pills off the street or swipe them from a
medicine cabinet, warnings about methadone's risks may have little impact.

Despite widespread publicity about the dire health consequences of
crack cocaine and methamphetamine, for instance, addicts still widely
abuse those drugs -- and methadone is much cheaper.

What might discourage someone tempted to sell methadone illegally,
however, is the possibility of a murder charge.

N.C. Sen. John Snow has proposed a change in state law that would
allow second-degree murder charges against anyone who illegally
provides the methadone that causes a fatal overdose.

While harsher penalties may help discourage the illegal sale of
methadone, the remedy for reducing deaths among legitimate users
should be obvious. Doctors need to stay abreast of the latest
prescription guidelines, and patients need to scrupulously follow
dosage instructions while paying attention to any symptoms of a
possible overdose.

As always, vigilance -- and competent medical care -- are the
patient's best defense.