To the Editor: A study by Dr Hall and colleagues1 of overdose fatalities in West Virginia in 2006 found that, relative to the amount of medication distributed, methadone was implicated far more frequently than oxycodone or hydrocodone (47.2, 3.9, and 3.0 deaths per 1000 g, respectively). One possible explanation offered was that “methadone is for unknown reasons favored by drug diverters. . . . ” This seems improbable given the very slow onset of action of methadone; drugs whose peak effectiveness occurs hours after ingestion are not popular among those seeking a high.
Newman R. Prescription Opioids and Overdose Deaths. JAMA. 2009;301(17):1766-1769. doi:10.1001/jama.2009.579