Methadone, used to help people kick heroine, growing in popularity and becoming more deadly
When Kathleen tried to kick her
heroin addiction in 2001, a well-meaning doctor sent her to a Cleveland methadone clinic.
But four years later, the 50-year-old Mentor woman, who once worked as a special education teacher for Cleveland Schools, said she remained trapped in that addiction frame of mind.
"Methadone kept me sick," the divorced mother of four said from the treatment center where she has been for 11 months. (Her real name is not being used for this article, at her request).
"The first thing I had to do in the morning was get 'dosed.' People don't realize how strong it is. It is legalized drug addiction. I don't know what the answer is, but it's not that."
Methadone, a synthetic narcotic long respected for treating heroin addiction and soothing chronic pain, is increasingly being abused by recreational drug users and is causing an alarming increase in overdoses and deaths, area and federal officials say.
In Lake County, methadone-related deaths increased from three in 2004 to eight in 2005, according to the county Coroner's Office.
In Cuyahoga County, Coroner Dr. Elizabeth Balraj said such deaths more than quadrupled in just one year - from four methadone-related overdoses in 2004 to 18 in 2005.
William "Trey" Edwards of the Lake County Narcotics Agency - whom Kathleen credits for saving her life after he arrested her last year for calling in
her own anti-anxiety prescriptions - dubbed methadone the fastest-rising killer drug.
"It's scary," Edwards said. "Methadone is one of the top drugs that results in overdoses."
Physicians are prescribing the drug more for pain management because it's cheaper and thought to be less addictive than other drugs.
"Doctors who maybe used to prescribe OxyContin for pain management are now prescribing methadone," the agent said. "It costs pennies for methadone compared to OxyContin. I also think because of the negative press associated with OxyContin, doctors are prescribing methadone, thinking it will work better. So many of these (patients) have legitimate issues. The doctors are out there trying to help people and get duped easily."
The increase in methadone overdoses and deaths has baffled many drug experts because methadone, which does not provide a quick or potent high, has long been considered an unlikely candidate for substance abuse.
It can be hours before a user feels any effect, and works more like a sedative than a stimulant.
But people who are out to abuse prescription drugs don't really care what they get, Edwards said. Methadone pills can be purchased for just 50 cents per milligram on the street - a lot cheaper than a heroin or OxyContin habit, he said.
Since methadone does not produce the euphoric rush associated with other drugs, users often consume dangerously large quantities of methadone - sometimes mixing it with alcohol or other drugs - in a vain attempt to get high.
"It's like, what's worse? Eight deaths from methadone or hundreds of people abusing OxyContin?" Edwards said.
Since methadone stays in the blood system longer, it can build up over time to a toxic level. That means abusers can take the same amount of the drug on a Friday and Saturday with no ill effects, only to die Sunday from the same dose.
"People take it thinking they're going to get high off of it, and they don't, so they take another one and another one and another one," Edwards said.
Methadone - which has been legally available in the United States since 1947 and is available in tablet, oral solution or injectable liquid form - has kept a low profile until recently.
According to the National Drug Intelligence Center, nearly 1 percent of the country's high school seniors admitted abusing methadone - also known as chocolate chip cookies, fizzies and wafer - at least once.
The majority of methadone overdose victims are white and in their 20s, according to the Manchester, Md.-based National Association of Drug Diversion Investigators Inc.
Some doctors and pharmacists say the drug can be dangerous because it suppresses breathing longer than it does pain, and may increase the risk of an abnormal heart rhythm.
"People don't realize they can shut down their respiration," said pharmacist Tim Williams of Euclid Family Pharmacy.
However, Williams added he thinks methadone is less addictive than other drugs often prescribed for pain.
The rise in methadone abuse appears linked to the growing abuse of heroin and the highly addictive OxyContin - dubbed "hillbilly heroin" - on the streets.
At the same time, methadone has become more available.
Methadone tablets are sometimes given to addicts by people who have stolen them from patients. In some cases, clinic patients sell the drug as a secondary source of income, as many clinics across the country have stopped requiring patients to take all their daily doses at the clinic.
"People sold the methadone 'juice' on the street," Kathleen said of her clinic years. "People would save their spit - not swallow it - and sell it on the way out. A lot of dealers who don't use would hang out there and prey on unsuspecting people."
Methadone is complicated to prescribe since doses are difficult to calibrate because of the way the drug is slowly released in the body, said Dr. Edward C. Covington, director of the chronic pain rehabilitation program at the Cleveland Clinic.
"Methadone is probably one of the few drugs that I've seen doctors almost kill patients with," Covington said. "It's that hard to use when you first start to use it. If it's on the street, we're going to start seeing some deaths."
Dr. Teresa Dews of Hillcrest Hospital in Mayfield Heights said she prescribes methadone for pain management only to a select group of patients.
"It can be very effective, especially for nerve pain," Dews said. "But it's a very tricky medication to work with. If people are not using the medication exactly as prescribed, the patient could overdose. Methadone is a very good medication. It's very appropriate for well-selected patients. But if patients are taking this medication, they should follow their doctor's instructions to the letter."