Methadone
Methadone, a drug long used for treating heroin addiction, is increasingly
being used by recreational drug users. It is causing an alarming increase in
overdoses and deaths. In Maine, methadone was the drug found most frequently
in people who died of overdoses from 1997 to 2002. It was found in almost a
quarter of the deaths. In the first six months of last year, methadone killed
18 people in Maine. This is up from 4 in all of 1997. Dr. John H. Burton, medical
director for Maine Emergency Medical Services, said hospital emergency rooms
were seeing "a tidal wave" of methadone-related cases.
The increase in methadone overdoses and deaths has floored many drug experts
because methadone, which does not provide a quick or potent high, has long been
considered an unlikely candidate for substance abuse. It can be hours before
a user feels the effect, and it works more like a sedative than a stimulant.
The surge in methadone use appears linked to several factors, including the
growing use of heroin and OxyContin, a powerfully addictive prescription painkiller.
Health and law enforcement officials are reporting that some of these addicts
are turning to methadone when they cannot get the other drugs. At the same time,
methadone has become more available. Physicians are increasingly prescribing
it for pain relief, in part because law enforcement officials have been cracking
down on OxyContin. Also, more methadone clinics have sprung up to treat the
growing number of heroin addicts.
"The availability of methadone for treatment and pain has put people who
would not normally be in a position to divert drugs into that position,"
said Sgt. Scott J. Pelletier. He works for the Maine Drug Enforcement Agency
handling drug cases in Portland and Cumberland County, where methadone caused
at least 30 deaths in 2002, according to the state medical examiner's office.
In most states with increased methadone deaths, the methadone being used appears
to be tablets prescribed for pain. These are sold or sometimes given to addicts
by people who have stolen them from patients, or in some cases, by the patients
themselves. Addicts either swallow the tablets or grind them into powder that
can be inhaled or turned into liquid and injected.
The authorities say much of the methadone has been the liquid form used in
drug clinics and spread, in some cases, by clinic patients. Many clinics across
the country, following federal guidelines designed to make methadone treatment
more accessible, have stopped requiring patients to take all their daily doses
at the clinic. Instead, they are allowing them to take home doses of methadone
once a week or more.
In Chicago, "kids are now coming from suburbia and they're buying methadone
on the street," said Dr. Ernest C. Rose, a specialist in drug addiction
who works for several methadone clinics there.
"In the inner city, you can get 80 milligrams of methadone for $20 to
$30, which is a lot cheaper than a heroin habit would be. We do see a lot of
methadone getting diverted out here on the street from the clinic, and we have
to watch our clients very carefully because it's a secondary source of income
for a lot of them."
There are no national figures for methadone deaths or overdoses. However, the
federal Drug Warning Network reported that in 2001, 10,725 people turned up
in emergency rooms after having used methadone. That is nearly double the number
of such visits in 1999.
Many people go from being addicted to heroin, to acquiring a methadone addiction.
They continue with this "treatment" for years, fearing the withdrawal
that will occur when they stop. Methadone does not have to be the way of life
for former heroin addicts. Gradual cessation followed by a drug-free program
of rehabilitation may be the answer for many sufferers.
Critics point out that methadone patients are still addicts and that methadone
therapy does not help addicts with their personality problems. In many cases,
multiple drug use and a strong psychological dependence undermine the gains
made. Some addicts manage to resell the methadone they receive in order to buy
heroin. This and other illegal diversion have resulted in methadone joining
the group of addictive drugs sold on the street.
Fraudulently acquiring methadone is becoming common practice among many individuals
with drug addictions. Methadone fraud can take several forms:
- conning a doctor into prescribing a higher dosage than is required
- taking more than the recommended dosage
- taking methadone in combination with other drugs, including alcohol
- using methadone as a 'top up' drug while continuing to take heroin
- selling prescribed methadone in order to buy heroin