Methadone-related deaths on rise: Can be lethal combined with antidepressants -- or grapefruit juice

LAT: Painkiller is part of a lethal mix
Increasingly prescribed and easy to find on streets, methadone leaves a trail of misuse.
By Charles Proctor, Times staff writer
February 25, 2007


A federal government study found that nationwide methadone-related deaths climbed to more than 3,800 in 2004 from about 780 in 1999. Among all narcotic-related deaths in 2004, only cocaine killed more people in the United States than methadone.
(Patrick Downs/LAT)


Anna Nicole Smith and her 20-year-old son Daniel: drug's victims? (AP)

Methadone, a potent opiate once used almost exclusively to treat heroin addicts, is increasingly being prescribed by doctors as a pain medication and abused by drug users searching for a cheap, easy way to get high, physicians and federal drug officials say.

The drug, which comes in pill or liquid form, recently has come under scrutiny in the death of former Playboy model Anna Nicole Smith. A doctor in Studio City prescribed methadone to Smith for pain treatment before she was found dead Feb. 8 in her Hollywood, Fla., hotel suite....Months earlier, Smith's 20-year-old son died in the Bahamas after taking a lethal mixture of methadone and two antidepressants, Zoloft and Lexapro....

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Given its low cost compared with heroin and other drugs, its recent proliferation and its potentially lethal potency when mixed with other drugs, officials worry that methadone is largely evading the scrutiny applied to other abused prescription medications, such as OxyContin and Vicodin.

The drug can be lethal even when mixed with antidepressants, or grapefruit juice, experts and federal drug authorities say.

Methadone can linger in body tissue for an unusually long time — 24 to 59 hours in some cases. Sometimes users assume it has worn off, then take other drugs or more methadone, leading to respiratory depression, coma and eventual death....

http://www.latimes.com/news/nationworld/nation/la-me-methadone26feb26,0,4449874.story?coll=la-home-headlines

I had been on methadone for about 3 years or so, then my pain management Doctor switched me to MSIR...Morphine sulfate immediate release. It's not as effective as methadone, but I understand why he had to change my meds. I suffer from chronic pain. Methadone did not kill the pain, but eased it. My new med does the same thing, but doesn't last as long.

Of course, I was not mixing other meds with my pain meds. The others I have been taking have been for acid reflux, high blood pressure, and depression. The switch didn't cause any reaction in me, other than noting that morphine isn't as effective as methadone. Pain management doctors have to be extremely careful in giving patients opiates, because of the really draconian drug laws in this country.

I don't get high from the use of morphine, as I felt no high taking methadone. What these drugs have done is to enable me to lead a semi-normal life. Some days, it doesn't even give me that. Some days, after I dress, I have to ask my husband to brush my hair, because the pain I'm in won't permit me to do it.

I wish the government could understand the difference between getting high, and merely coping with life. I don't think they will. The pharmaceutical companies have too much invested to ever let there be a cheap, available pain reliever. If I could smoke pot, I think I'd be in much beater shape. I have to have a blood test every three months, though, because of the pain meds.

For some people suffering from chronic, intense pain, such as myself, if we could sign a waiver releasing our doctors from being liable for your deaths if we take certain drugs, I think that many of us would gladly sign, and take our risks. Unfortunately, we are not given that choice.

your personal experience in this post. It's really helpful in understanding the problem of those who need these kinds of medications to get through day-to-day life.

Have you tried Lyrica? New but expensive. Also I have always wondered how people on narcotics get around. Do you drive? And if so how can that be done safely while taking something as potent as morphine? BTW I hope your MD can find something to ease your pain.

when you have A LOT of pain- the narcotics work on that, and your body builds a tolerance. opiates actually cause insomnia(notice when i'm posting?)

now what you mean about the insomnia. I had a spinal fusion c5-c6. I take hydrocodone 10mg but only at home. I take naproxyn in the am. I worry about being behind the wheel while on the hydros

7.5mg hydrocodone 200mg ibuprofen- many times i take them together with the methadone.

the thing that's worse than the insomnia is the costipation. every time i pick up my methadone at the pharmacy, i get a coupon for 50 cents off on stool softener.

60-70 mgs/day, for the past 6 years or so...i used to take oxycontin, but when my insurance company dropped me, my doctor put me on methadone because it's much cheaper.
and no, it doesn't get me "high" either, it just keeps me from lying in bed curled into a fetal position- in other words, it allows me to live a normal life.

the biggest pain in the ass about being on methadone, is that the prescription has to be hand-written every month- no refills, no phoning it in...i have to go to the doctor's office to get it every month.
luckily, though- i get it through my regular physician, and not one of those so-called "pain clinics"- i went to one of those once- they treat EVERYONE who comes through the door as if they are a junkie- is that why you have to get a blood test? and is your blood test specifically a drug test?
i get my blod tested several times a year, but it's not a drug test...and unless they go looking specifically for pot in your blood, they won't find it. i smoke weed like a mad man...btw, because it acts as a bronchial dilator, pot actually helps in regard to the repiratory problems associated with methadone use.

btw- the condition that causes my pain is ankylosing spondylitis- a slow fusion of the spine...for me, it went un/mis-diagnosed for about 16 years, during which time pot was my ONLY source of pain relief.

I have that (ankylosing spondylitis) and lately my toes lock into weird painful positions and stay like that, I have to manually move them. I have to work, couldn't get disability and have no health insurance. So I am fucked, no pain meds either, just nothing but work and pain.

I also had a c5-6 and c 6-7 fusion 7 years ago and it still hurts.

I wish I had some methadone right now.

I go to this christian charity clinic but they won't write anything even though they keep telling me that I need it and I need a nuerosurgeon to look at me. It's against their rules to write pain medicine

i'm sorry to hear that you're having so many problems...i was able to qualify for permanent disability when i was 38, and i just turned 46. were your spinal fusions surgical, or caused by the AS?

as far as qualifying for disability- how many times have you been turned down? NOBODY gets approved on the first try, unless you're a blind quadrapelegic. i'd reccomend getting an attorney that specializes in social security disability cases- it's well worth it.

I just can't afford to stay unemployed long enough to get disability so I just force my way through (taking anything I can find otc and otherwise to put me in denial during the day) and in pain at night. Big huge catch 22 trying to get on disability when you have bills to pay. I was turned down 3 times when I gave up and went back to work. Single mother with a kid what are you going to do.

first of all- if you have AS, you NEED to cut out all of the starch from your diet. for an explanation as to why- go to this website: http://www.kickas.org/as_dietary_primer.shtml
the rest of the site is a good resource for AS sufferers as well. look around.

second- i've found that if i take 200-400mg of ibuprofen right before going to bed, that it helps me better sleep through the night, as well as wake up with a whole lot less pain.

that sucks, being turned down 3 times...i made it on my 2nd attempt- but my body is already pretty fucked up.

btw- are you within driving range of canada, or know someone who lives there? maybe another DU'er...?
in canada, you can get am otc pain-reliever called 222's...they're like excederin with codiene, and i reccomend them HIGHLY, if you have a way of getting some from canada. they are not available in the US.

Ibogaine, and extract of the tabernathe iboga plant from west africa has been proven to be an effective means of rehabbing heroin addicts with a single dose. Of course it's illegal in the US.

http://en.wikipedia.org/wiki/Ibogaine

had me seeing a pain specialist for many years... Methadone did not help me, Dilaudid did...

It is weird after a few years of taking this medication how you don't feel normal unless you are taking it... The body builds up a tolerance, meds have to be adjusted. By the time I made the decision to stop all narcotics I was taking Dilaudid , Loratab 10, soma and neurontin.... They were also talking about inserting a catheter into my shoulder for injections of pain medication....


That was 3 years ago.. Today I take Neurontin and Somas and occasional Lortab when it gets so bad I can't stand anything... I feel better not taking all the drugs. I was lucky I could do it, my Dr's said it was not possible but I did it anyway....