Prescription Painkiller Overdoses: Methadone

More than 15,500 people die every year of prescription drug overdoses, and nearly one-third of those overdoses involve the drug methadone, according to a recent CDC Vital Signs report. Researchers found that while methadone accounts for only 2 percent of painkiller prescriptions in the United States, it is involved in more than 30 percent of prescription painkiller overdose deaths.
Methadone has been used for decades to treat drug addiction, but in recent years it has been increasingly prescribed to relieve pain. As methadone prescriptions for pain have increased so have methadone-related fatal overdoses. CDC results showed that six times as many people died of methadone overdoses in 2009 as died in 1999.
The CDC Vital Signs report discusses this problem, shares data on methadone overdose death rates, and suggests prevention measures that can help.

The Problem

The Federal Government is:

Enforcing federal laws to prevent nonmedical use of methadone.

Educating health care providers and the public about the correct use of methadone.

Tracking prescription drug overdose trends and the impact of efforts to stop overdoses.

Methadone is frequently prescribed for pain.

Methadone, like other painkillers, is commonly prescribed for chronic problems like back pain even though it might not help these problems in the long run.

More than 4 million methadone prescriptions were written for pain in 2009, despite US Food and Drug Administration (FDA) warnings about the risks associated with methadone.

Methadone is available as a low-cost generic drug. It is often listed as a preferred drug by insurance companies.

Methadone's risks include:

The difference between prescribed doses and dangerous doses of methadone is small.

Methadone has special risks as a painkiller. For example, taking it more than 3 times a day can cause the drug to build up in a person’s body, leading to dangerously slowed breathing.

Methadone can seriously disrupt the heart’s rhythm.

Methadone can be particularly risky when used with tranquilizers or other prescription painkillers.

In one study, four in ten overdose deaths involving single prescription painkillers involved methadone, twice as many as any other prescription painkiller.

Steps for Safety

States can

Develop and promote the use of safe prescribing guidelines for methadone.

Support the use of methadone as a treatment for opioid dependence in opioid treatment programs.

Use prescription drug monitoring programs to identify patients who are using methadone or other prescription painkillers for nonmedical purposes.

Health care providers can

Follow guidelines for prescribing methadone and other prescription painkillers correctly, including
- Screening and monitoring for substance abuse and mental health problems.
- Prescribing only the quantity needed based on the expected length of pain.
- Using prescription drug monitoring programs to identify patients who are misusing or abusing methadone or other prescription painkillers.
- Monitoring patients on high doses of methadone for heart rhythm problems.
- Educating patients on how to safely use, store, and dispose of methadone and how to prevent and recognize overdoses.

Health insurers can

Evaluate methadone’s place on preferred drug lists.

Consider strategies to ensure that pain treatment with any dose higher than 30 mg of methadone a day (the recommended daily starting dose) is appropriate.