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- Confronting a Drug Abuser
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Methadone, a drug long used for treating heroin addiction, is increasingly being abused by recreational drug users and is causing an alarming increase in overdoses and deaths. In Maine, methadone was the drug found most frequently in people who died of overdoses from 1997 to 2002. It was found in almost a quarter of the deaths. In the first six months of last year, methadone killed 18 people in Maine, up from 4 in all of 1997. Dr. John H. Burton, medical director for Maine Emergency Medical Services, said hospital emergency rooms were seeing "a tidal wave" of methadone-related cases.
The increase in methadone overdoses and deaths has floored 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 the effect, and it works more like a sedative than a stimulant.
The surge in methadone abuse appears linked to several factors, including the growing abuse of heroin and OxyContin, a powerfully addictive prescription painkiller. Health and law enforcement officials are reporting that some of these addicts are turning to methadone when they cannot get the other drugs. At the same time, methadone has become more available. Physicians are increasingly prescribing it for pain relief, in part because law enforcement officials have been cracking down on OxyContin, and more methadone clinics have sprung up to treat the growing number of heroin addicts.
"The availability of methadone for treatment and pain has put people who would not normally be in a position to divert drugs in that position," said Sgt. Scott J. Pelletier, who works for the Maine Drug Enforcement Agency handling drug cases in Portland and Cumberland County, where methadone caused at least 30 deaths in 2002, according to the state medical examiner's office.
In most states with increased methadone deaths, the methadone being abused appears to be tablets prescribed for pain. These are sold or sometimes given to addicts by people who have stolen them from patients or, in some cases, by the patients themselves. Addicts either swallow the tablets or grind them into powder that can be inhaled or turned into liquid and injected.
The authorities say much of the methadone has been the liquid form used in drug clinics and spread, in some cases, by clinic patients. Many clinics across the country, following federal guidelines designed to make methadone treatment more accessible, have stopped requiring patients to take all their daily doses at the clinic, and instead are allowing them to take home doses of methadone once a week or more.
In Chicago, "kids are now coming from suburbia and they're buying methadone on the street," said Dr. Ernest C. Rose, a specialist in drug addiction who works for several methadone clinics there.
"In the inner city, you can get 80 milligrams of methadone for $20 to $30, which is a lot cheaper than a heroin habit would be. We do see a lot of methadone getting diverted out here on the street from the clinic, and we have to watch our clients very carefully because it's a secondary source of income for a lot of them."
There are no national figures for methadone deaths or overdoses. But the federal Drug Abuse Warning Network reported that in 2001, 10,725 people turned up in emergency rooms after having abused methadone. That is nearly double the number of such visits in 1999.
Many people go from being addicted to heroin to being acquiring a methadone addiction, and continue with this "treatment" for years, fearing the withdrawal that will occur when they stop. Methadone does not have to be the way of life for former heroin addicts. Gradual cessation followed by a drug-free program of rehabilitation may be the answer for many sufferers.
Critics point out that methadone patients are still addicts and that methadone therapy does not help addicts with their personality problems. In many cases multiple drug use and a strong psychological dependence undermine the gains made. Some addicts manage to resell the methadone they receive in order to buy heroin; this and other illegal diversion have resulted in methadone joining the group of addictive drugs sold on the street.
Fraudulently acquiring methadone is becoming common practice among many individuals
with drug addictions. Methadone abuse can take several forms:
- conning a doctor into prescribing a higher dosage than is required
- taking more than the recommended dosage
- taking methadone in combination with other drugs, including alcohol
- using methadone as a 'top up' drug while continuing to take heroin
- selling prescribed methadone in order to buy heroin