Methadone linked to 30 percent of prescription painkiller overdose deaths

The prescription drug methadone accounted for 2 percent of painkiller prescriptions in the United States in 2009, but was involved in more than 30 percent of prescription painkiller overdose deaths, according to a CDC Vital Signs report released today by the Centers for Disease Control and Prevention.

Researchers analyzed national data from 1999-2010, and 2009 data from 13 states (those covered by a surveillance system for drug-related deaths, the Drug Abuse Warning Network of the Substance Abuse and Mental Health Services Administration).

Methadone carries more risks than other painkillers because it tends to build up in the body and can disrupt a person’s breathing or heart rhythm. According to the report, 4 of every 10 overdose deaths from a single prescription painkiller involved methadone, twice as many as any other prescription painkiller.

Methadone has been used safely and effectively for decades to treat drug addiction, but in recent years it has been increasingly used as a pain reliever. As methadone prescriptions for pain have increased, so have methadone-related nonmedical use and fatal overdoses. CDC researchers found that six times as many people died of methadone overdoses in 2009 compared to methadone-related deaths in 1999.

“Deaths from opioid overdose have increased four-fold in the past decade, and methadone now accounts for nearly a third of opioid-associated deaths,” said CDC Director Thomas R. Frieden, M.D., M.P.H.  “Methadone used for heroin substitution treatment does not appear to be a major part of this problem.  However, the amount of methadone prescribed to people in pain has increased dramatically. There are many safer alternatives to methadone for chronic non-cancer pain.”

Despite recent federal efforts to warn health care providers that methadone prescribing is complex and that methadone should not be the first choice as a pain reliever, the number of methadone prescriptions has not declined significantly. The majority of these prescriptions are written by practitioners who typically do not have special training in pain management.