ATTACK HEROIN NOT METHADONE
I am posting below a brilliant letter by Alex Wodak, MD submitted for editorial to The Times.
Wed, 25 Jul 2007
Subject: Attack heroin not methadone
Dear Sir,
The recent report (The Times, 23 July 2007, Services failing the children of 7,000 drug addict parents, Charlene Sweeney) into treatment services for drug dependent parents in Scotland attacks the most effective response rather than focusing on the real problem. If Ms Annabel Goldie really wants to listen to experts, she should read the 2005 joint
endorsement of methadone by the United Nations Drug Control Programme, the World Health Organisation and UNAIDS. In 2005, WHO added methadone to its list of Essential Medicines. Methadone and buprenorphine treatment are remarkable for their ability to attract, retain and benefit large numbers of heroin users.
Abundant research confirms that methadone substantially reduces deaths, heroin use, crime and HIV infections. In a 2006 study published in The Lancet, methadone treatment in Zurich reduced the number of new heroin injectors from 850 in 1990 to 150 in 2002 with a large decrease in deaths, crime, HIV infections and heroin seizures.
Supervision of methadone treatment reduces diversion to the black market while inadequate methadone treatment increases the black market. All over the world, methadone treatment is grossly under funded. Consequently, programs have insufficient capacity and quality. Residential treatment programs for heroin users attract few, retain even fewer and are expensive. Finding evidence of benefit is very difficult. Yet they have their place as some drug users will always reject or not receive benefit from methadone treatment.
Yours sincerely,
Dr. Alex Wodak,
Director, Alcohol and Drug Service,
St. Vincent's Hospital,
Darlinghurst, NSW, 2010,
AUSTRALIA
posted by RGNewman, MD @ 1:45 PM
7 comments
7 Comments:
Methadone is now the #2 Killer Drug in the U.S. and #1 death per prescription. This is a legal drug that has been thought to be safe for the past 40 years. Only recently when its use became approved for pain management patients has the cardio toxic risks emerged. Previously methadone has been used exclusively for replacement therapy for heroin patients and death was thought to be an effect of the accumulation of many years of drug abuse. With the surge in pain medication misuse and abuse more patients are being referred to methadone clinics and physicians treating pain who believe the myth that methadone is safer or non addictive because of it’s use with weaning addicts from heroin. Methadone is more addictive then any other pain medication including heroin and because of it’s extremely long half life, cardio toxic risks, numerous fatal drug interactions, dosages based on tolerance, and small margin of error. Up until Nov 2006 the government and pharmaceutical companies have been suppressing the numerous health and fatality risks related to methadone.
there are between 800,000 & 900,000 (some stats give diff numbers) heroin addicts in the U.S and 1,881 people died from heroin in the U.S. in 2004.
there are 200,000 people on methadone for drug treatment and I don't have the number of people on it for pain but even if we double the 200,000 and assume it's 400,000 total people on methadone there were 3,849 deaths in 2004
It looks like the "gold standard" is killing more then the drug its supposed to save people from!!!!
Every day 10.9 people die from Methadone (according to 2004 stats)
We (the families of methadone victims) are requesting new laws surrounding who can prescribe Methadone, clinic rules and regulations as well as stiffer penalties for those caught selling their take home doses. The whole methadone maintenance system needs an overhauling. We cannot continue to allow a legal medication to be killing more people then the illegal drugs. Our government cannot be allowed to use tax dollars to fund their legal drug dealing operations.
We are asking government agencies to enact stricter guidelines in prescribing methadone for any reason. It must be mandatory that all doctors be certified and trained in the pharmacology of methadone; inpatient stays must be required during induction to methadone; all staff be extensively trained in monitoring methadone patients for symptoms of toxicity. Clinic patients should be tested weekly for legal and illegal drugs that are taken with methadone to get “ hi gh” or experience “euphoria” such as benzodiazepines, alcohol, cocaine, heroin, marijuana etc… and face severe consequences or mandatory detoxification from the methadone program after 3 dirty urines. Selling of take home doses must result in termination from methadone program permanently throughout the U.S. When presenting inebriated at clinic, clinic should also document such activity as well as prevent client from driving. Take home doses for all patients receiving methadone should be eliminated thus preventing the risk of diversion or precautions such as pill safe should be implemented. http://www.thepillsafe.com/
Current statistics show that nearly 4000 people a year die from methadone. These deaths are mostly happening to pain management and detoxification patients’ wit hi n the first 10 days of taking initial dose. Most of these deaths are related to methadone prescribed with other medications that react as additives with the methadone. Diversion of methadone is a serious problem because it lands t hi s most deadly drug on streets. Statistics also state that methadone is contributing to more deaths nationwide then heroin and only second to cocaine deaths.
The potential of abuse, diversion, and overdose to new patients being prescribed methadone is overwhelming. The unique properties of methadone, it's long half life, and it's negative interaction with numerous drugs make it an optimal choice as a last result treatment for chronic pain and addiction.
Thank you for taking the time to read this letter.
Sincerely
Melissa Zuppardi
www.HARMD.org
the outrage of HARMD writer M.Z. is misplaced, and her lead sentence explains why: "Methadone is now the ... #1 death per prescription." This may or may not be accurate, but NOTE THAT METHADONE FOR TREATMENT OF ADDICITON MAY NOT BE PRESCRIBED AHYWHERE IN THE USA. It's given under severe federal and state restrictions in "comprehensive treatment programs," with take-home meedication limited to stable patients who have been in treatment for months.
To the exctent methadone is involved in deaths, it's overwhelmingly due to the prescribing of the medicaiton for pain. And indeed this is precisely what has been found and reported consistently by the US government for several years. Safer prescribing for pain, yes - in dosages that are both effective and safe, and methadone is an extremely effective AND SAFE medication for pain when prescribed appropriately.
Recommending constraints on the use of methadone for addiction will simply increase further the barriers to effective care for those who may want and need this medication, and all too often die without it.
Responding to 'mells 11577' quote"Methadone is now the #2 Killer Drug in the U.S...".Uquote.
This is nonsense, first we have Tobacco, then Alcohol both of which are drugs.
Here in the UK, we give methadone too, however, the national average dose is less than 40ml per day.
The 1999 Guidelines, recommend doseage of 60ml-120ml per day, with exceptions.
Therefore, most patients who are receiving methadone as their only perceived way of staying off heroin, and, stable to be gamefully employed and dependable for their spouse/family/freinds.
However, I see many people in a state of suffering almost all the time.
The small amount of methadone just may take the 'edge off' when they wake up each morning but then they have to get out and get some heroin. Which is completely understandable, however, when we say heroin, what these bags of heroin contain is anyones guess, they have some heroin perhaps to the extent of 40% the remaining 60 percent can be camel dung, brick dust, as said anyones guess.
This is not the 'rationale' which Dole & Nyswander, made this medicine available. The 'rationale' of methadone is to titrate the dosage upwards slowly but steadly until the patient suffers no more feelings of withdrawal syndrome within the 24 hours.
Once free of these symtoms which come and bring 'uncontrolable' cravings for heroin, once free of these then the patient has a chance at leading a normal life style.
Unfortunately, that seems unlikely here as the treatment expenditure is to be cut considerably over the next three years.
Added, to the problem is that Local Authorities, only want a patint on the books for 12 weeks, the exact amount of time that local gov; has to send quarterly reports to central government. Therefore, what we have is the 'Revolving door'effect whereby on patient is somehow kicked off treatment or is made to sign a contract for treatment of 12 weeks only when joining drug-agency, then he cannot apply for treatment for six weeks in which he/she is on the streets and then back in to the clinic where they can count the patient twice three times or until the streets kill them.
Ian Harris
Dagenham
Nr. London U.K.
Methadone is under the urisdiction of the DEA and not the FDA which gives you a very clear understanding of how the drug is viewed by government and the public at large. It is the most regulated drug in history and most clinics only allow for 13 day take-home doses which clearly limits an individual's freedom. Regulation has created a situation where a private pay is well over 500 a month with not one major insurance carrier paying any portion of that bill. And, as the addict finds him or herself at the absolute bottom of the foodchain, powerless to make any real change. Most of those who oppose methadone the loudest have no real understanding of how well it works for those who will let it work and consider it merely exchanging one drug for another. Oxycontin abuse can created this absurd rush to use methadone as an analgesic and like the anti-gun forces, the anger and blame is completely misplaced. The real cost of a dose of methadone is around $2 and not the grossly inflated $16 that covers an army of counselors, accountants, nurses and others. Less control for those who have proven their ability to use methadone as a tool to a better life and enough control for those willing to try methadone as an answer to opiate dependency. The pain and suffering of the drug addict is a subject of derision for the vast majority of the population and the very idea of methadone is anathema to most. And this is 30 years after its introduction as a treatment modality.
HI,
I USE TO STEAL ALMOST ANYTHING TO BUY HEROIN,I WOULD BREAK INTO CARS STEAL THE STERO AND SPEAKERS PLUS ANYTHING THEY LEFT.I WOULD STEAL CAR TIRES WELDING CABLES FOR COPPER COPPER IS NOW OVER $2.50 PER POUND.ON GOOD NIGHTS WE WOULD STEAL OVER 2,000 POUNDS OF COPPER
THATS $4,500.I STOPPED ALL OF THAT AND GOT ON TO METHADONE IF I DID NOT I WOULD BE IN JAIL NOW OR DEAD.
NOW THAT I HAVE BEEN ON METHADONE
NO NEED TO SPEND CASH,I JUST BOUGHT
A BRAND NEW HARLEY DAVIDSON A SOFT TAIL FAT BOY IF I WAS STILL ON HEROIN I WOULD HAVE NOTHING AT ALL
I BELIVE METHADONE SAVED MY LIFE
OR A LIFE IN JAIL FOR SURE METHADONE IS NOT THE #2 KILLER
ALCOHOL& PILLS SMOKING AND DRINKING THAT HARD MOON SHINE WHO EVER SAID METHADONE IS THE #2 KILLER IS NOT STREET WISE THEY ARE TOTALLY A JACKASS
Just because Methadone helped u kick your Heroin habit, doesn't mean it is not the #2 killer drug. How can u soley base your own personal drug addiction and theft issues as the reason Methadone is not the #2 Killer Drug?
I would also like to know where I can find this list on the top Drug Killers in the US. So far as I can find; Alcohol is #1 and Methadone is #2. But where can u find this list of Killer Drugs? Minus of course the google search for "Killer Drugs" "top 10 Killer Drugs" or even "Dangerous Drugs?"
LOL.
And I am serious. I would really like to find out what comes next.
I came across this blog during a search to find out if combining Geodon and Methadone is safer than combining Morphine and Geodon.
Ha. One of my many "I must find out all I can about this, and hey, what is this? Now I must find out about this!" nights.
haha
~M
I am currently on methadone and have been for years. I could not of got where i am now without it. I was a total wreck with drugs and it has stablized me. I have got my children with me now and i am focused. It is definately helping people, it changed my life. I hope the government dont make it just a 12 week detox because i couldnt do without it as i am on a maintenance dose and ive been told i can stay on it until i am ready to come off it.
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