IN RESPONSE TO THE NY TIMES "METHADONE RISES AS A PAINKILLER WITH BIG RISKS" (Aug 17):

Here are two non-published LTEs in response to the NY Times Article on August 17th:

Erik Eckholm’s article about the increasing use and related risk of prescribing methadone for pain management was a carefully researched, balanced piece. Physicians need to be trained in the proper use of this medication as part of an effective risk management program and medical examiners need to use standardized methods in assessing methadone-associated mortality. This medication has been used safely and effectively with ancillary clinical services in treating chronic opioid addiction for more than 40 years in certified and regulated opioid treatment programs. It has helped millions of patients worldwide. Thank you for your thoughtful article.
Mark Parrino, President of the American Association for the Treatment of Opioid Dependence (AATOD)

re: "Methadone rises as a painkiller with big risks" (Aug 17), a Food and Drug Administration (FDA) official is quoted as saying that "label changes" reducing the recommended methadone dosage from 80 mg to 30 mg were instituted "as soon as we became aware of deaths due to misprescribing for pain patients . . . " This claim is difficult to reconcile with the fact, reported in your article, that as early as 2003 FDA was "alarmed by the rise in methadone-related deaths." Also, FDA had for decades called for an upper limit of 30 mg methadone for patients starting treatment for addiction, who have a tolerance to opiates that, at the outset, pain patients generally lack.

Allegations of "misprescribing" divert attention from the real issue here: How can one explain years of explicit, potentially lethal, dosage recommendations by both FDA and the manufacturers, who surely knew better?
Robert Newman, Director of Baron Edmond de Rothschild Chemical Dependency Institute, NYC