The drug methadone is involved in about one-third of all deaths caused by opioid pain relievers (OPRs), according to recent government estimates.
In a new report filed by the U.S. Centers for Disease Control and Prevention (CDC), the number of deaths linked to methadone is far out of proportion to its use, significantly exceeding multidrug and single drug deaths involving other opioids.
As a result, the CDC is pushing for doctors to be much more reserved in their prescribing of methadone and other opioids.
National data was assessed by researchers from 1999 to 2010, as well as data for 2009 from 13 states covered by a drug-related death surveillance network. In 2010, methadone accounted for between 4.5% and 18.5% of the opioids distributed by state, but was involved in 31.4% of OPR deaths in the 13 states. It also accounted for 39.8% of single-drug OPR deaths.
Methadone, also known as dolophine, is a psycho-active drug that is used to relieve chronic pain in cancer patients and as a maintenance drug to control withdrawal symptoms in people undergoing treatment for opiate addition. It belongs to the class of opioids, drugs that share some of the analgesic properties, and mimic the action of some of the body’s naturally occurring chemicals called peptides, such as endorphins and enkephalines. In opiate addiction treatment, methadone blocks the opioid receptors of the brain that bind opiates such as heroin.
The CDC recommends that methadone and other, extended-release opioids should not be used for mild pain, acute pain, “breakthrough” pain, or on an as-needed basis. For chronic non-cancer pain, methadone should not be considered the first drug of choice.
Deaths involving prescription drugs in the U.S. has been an ongoing problem. In 2009, the number of fatalities involving overdose surpassed those from car accidents. According to data from the CDC, at least 37,485 people died from a drug overdose in 2009, compared to 36,284 who died in car and truck accidents that same year.
The Food and Drug Administration (FDA) estimates that more than 33 million Americans age 12 and older misused extended-release and long-acting opioids during 2007—up from 29 million just five years earlier. And in 2006, nearly 50,000 emergency room visits were related to opioids.
In response to the growing problem, the FDA has initiated a Risk Evaluation and Mitigation Strategy (REMS) for all extended-release and long-acting opioid medications. The strategy involves educating doctors about proper pain management, patient selection, and other requirements and improving patient awareness about how to use these drugs safely.