 |
|
|
July 28, 2003 Contact: Jim Sellers (503) 945-5738 Technical contact: Mel Kohn, M.D. (503) 731-4023 Methadone use, deaths reported increasing in Oregon An Oregon Department of Human Services (DHS) review of methadone-related deaths reveals a 4-fold increase since 1999. Of the 245 methadone-related deaths that Oregon recorded between 1992 and 2002, 103 (nearly 45 percent) occurred in 2002. "Although methadone is widely used without a problem, this recent increase in deaths is concerning," said Mel Kohn, M.D., state epidemiologist in DHS. "Patients who take methadone need to understand the special properties of this medication so they can safeguard themselves. Health-care providers also should take extra care to make sure their patients are well-informed about these aspects of methadone." Methadone is a long-acting synthetic opiate that the federal Food and Drug Administration approved for medical use in 1947. It was approved for the treatment of heroin addiction in 1972 and more recently has been used increasingly for chronic pain. The increase in methadone deaths in Oregon occurred among those who were using it for heroin addiction and for chronic pain. The largest increase in deaths was among those taking methadone for pain. Most of those who died had taken other drugs in addition to methadone, according to Kohn. "Methadone takes time to build to an effective level in the body and every person metabolizes the drug differently," Kohn said. "A patient who seeks rapid relief by adding other drugs could be making a deadly decision. Taking extra doses is also dangerous, because methadone is broken down slowly by the body. It can build up insidiously over time until it reaches a fatal level." Kohn said many of those who died were reported to be extremely drowsy, difficult to awaken and loudly snoring. "Caregivers of people taking methadone need to know that those signs could be an early warning sign of danger," he said. The increase in deaths parallels an increase in methadone distribution. Between 1997 and 2001, methadone distribution in Oregon increased 5-fold; nationally it increased 3.5-fold. Oregon now ranks fifth nationally in the amount of methadone distributed per 100,000 persons. The increase in methadone use nationwide may be due to its low cost and a lack of alternative medications with similar properties, particularly for pain control, according to Kohn. "Oregon's use of methadone may be particularly high because of our strong focus on pain management," he said. The review suggests that health systems may want to address the problem through strategies such as automatic reminders to pharmacists and providers about the danger of dispensing another drug when methadone is prescribed. "We don't know the effect of such systematic approaches, but a careful evaluation of their impact could help guide future policy change," Kohn said. The review is the topic of the new CD Summary, a bi-weekly newsletter sent to Oregon physicians and other health professionals. |
|
