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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
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in toxic levels.2-4 Thus, a few states have reported a recent rise in methadone-related deaths.5,6 However, these unpublished reports include deaths in which methadone only appears as a toxicological finding and contain limited information beyond the drugs involved.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.
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