1. What is Methadone, and what is it used for?
Methadone is an opioid, a narcotic drug, that was developed over fifty years ago to treat patients with heroin addiction. It is also a very effective pain medication, like morphine.

2. What is contributing to the increase in methadone deaths?
We don't know for sure. There is some evidence that patients will overuse the medication (take more than prescribed) in an effort to escape pain. One pill is often not enough, and two may be more effective. However methadone is unique in that the length of time it provides pain relief is only 4-8 hours while its effect on suppressing breathing may last for 2-3 days. When first given methadone patients have not developed a tolerance to the breathing depressant effect, and repeated dosing can cause some patients to stop breathing (usually at night when there are fewer stimuli to breath).

There also appears to be a small group of patients who converted from one opioid to methadone at a level that could be dangerous. This can occur when physicians use a conversion table that suggests an equal dose of two opioids. When this happens, the starting dose of methadone could be high enough to stop respiration.

Another risk factor could be sleep apnea. Some patients may be at increased risk of harm if they have sleep apnea or are taking a valium-like drug. Patients taking a valium-like drug together with methadone appear to have a much greater risk of life-threatening sleep apnea.

Consuming alcohol while using methadone or any strong pain reliever can cause breathing to slow or stop.

3. What are the symptoms of someone who has had an overdose of methadone?
The worst symptom is when no breathing occurs. This, of course, is when it is too late. Early symptoms of too much of any pain reliever are when patients are excessively sedated, can not stay awake or snore heavily, often with a slow respiratory rate.

4. Does this drug build up in your system over time?
The drug will accumulate in the body, which may not be bad if the starting dose is low and gradually increases as the body becomes used to the drug. This is how we can reach a level that will help relieve pain but not cause adverse effects.

5. Is it safe to use Methadone to wean off other medications?
Methadone is used to treat opioid addictions. It is used instead of other opioids because it stays in the body for a long time decreasing the craving to use an illicit opioid. Again, this can be safe but if the starting dose is high or valium-like drugs are used with methadone, it may be very dangerous.

6. What is the Zero Unintentional Deaths Campaign’s biggest concern about methadone?
That it will not be available to patients who need it because of the increased deaths that have been associated with its use.

7. What is the history of Methadone?
Methadone was developed over 50 years ago, but it was used primarily for the treatment of addiction until the late 1980's. Around the year 2000 here was a surge in methadone prescription due to a lot bad press around Oxycontin. Physicians became concerned that they would be accused of contributing to opioid addiction so they started to prescribe methadone instead. Physicians felt it was safer and less risky than other opioids in particular Oxycontin.

8. What does the Zero Unintentional Deaths Campaign want to tell the public about Methadone and its dangers?
The most important message the public must hear is that all pain relievers, including methadone, are powerful medications. Not enough respect is paid to the power behind these medications. They are intended to be used as physicians prescribe them, not as patients feel they need them. Too often patients use pain medication as if it is aspirin or ibuprofen -- if one pill helps a little, then two must help a lot. This careless approach can be lethal.

Six Steps to Zero

1. Never take a prescription painkiller unless it is prescribed to you.
Everyone responds differently to pain medications. What is safe for one person may not be safe for another.

2. Do not take pain medicine with alcohol.
Never mix the two; it is a dangerous combi¬nation that can be deadly. Alcohol increases the toxicity of pain medication.

3. Do not take more doses than prescribed.
Even after the effects of pain medicine seem to have worn off, it is still depressing the respiratory system. Some medications like methadone may relieve pain for a few hours but will have a prolonged respiratory depressant effect. The body must develop a tolerance to the respiratory depressant effects before the dose can be increased.

4. Use of other sedative or anti-anxiety medications can be dangerous.
Combining pain medicines with other sedative drugs, such as valium, can increase the toxicity of the pain medication. Only take other medi¬cations, if directed by the prescribing doctor.

5. Avoid using narcotic medications to facilitate sleep.
Narcotic medications can suppress respiration during sleep. Speak to your physician about safe methods to manage pain during sleep.

6. Lock up prescription painkillers.
If consumed by children or other family members, or stolen and sold on the street, prescription pain medicine can kill.