Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Methadone traditionally has
been used to treat opiate addiction, but in recent years has been used increasingly
for management of chronic pain. In North Carolina, for instance, there was
a 4-fold increase in the amount of methadone sold to pharmacies and hospitals
between 1997 and 2001,1 probably reflecting
the increased use of methadone for pain management. However, because the analgesic
effect of methadone lasts less than 12 hours while its plasma half-life can
last for up to 72 hours, frequent dosing can result in toxic levels.2- 4 Thus, a few
states have reported a recent rise in methadone-related deaths.5,6 However,
these unpublished reports include deaths in which methadone only appears as
a toxicological finding and contain limited information beyond the drugs involved.
We examined deaths due to methadone in North Carolina between 1997 and 2001,
and ascertained the manner by which methadone had been obtained.
Ballesteros MF, Budnitz DS, Sanford CP, Gilchrist J, Agyekum GA, Butts J. Increase in Deaths Due to Methadone in North Carolina. JAMA. 2003;290(1):40. doi:10.1001/jama.290.1.40