Report: Methadone tradeoff's high price

DULUTH, Minn. (AP) — Nearly 400 people in Minnesota have died in the past 12 years of overdoses involving methadone, which is used to treat opiate addiction, the Duluth News Tribune reported.

Methadone has been used to break the cycle of addiction since the 1960s. Proponents say it's better to have addicts functioning on methadone despite the risks than breaking laws to score other narcotics such as heroin and Oxycontin.

But the trade-off comes at a steep cost. The Duluth News Tribune says that its analysis of state government data suggests methadone's track record doesn't compare favorably with other drug treatment programs. It says only 5 percent of patients successfully complete methadone treatment in Minnesota.

And as the number of deaths has increased, so has the cost to taxpayers. Half of the methadone patients in Minnesota are on some sort of public assistance - and some of the methadone paid for by public money winds up being sold on the streets.

"Huge quantities of illegal methadone are being used in the communities and being used without a prescription or without medical direction," said Phil Norgaard, director of human services for the Fond Du Lac Band of Lake Superior Chippewa.

At least 11 methadone deaths since 2001 were among people with ties to the tribe.

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"If this were bird flu, we'd be on the cover of Time magazine. We'd be in front of the cameras on `60 Minutes,"' said Phil Norgaard, director of human services for the band. "This is a threat to public health."

Minnesota Department of Human Services data show that patients discharged from methadone treatment programs have higher rates of relapse - are jailed more - than those coming off the state's other chemical dependency treatment programs.

Agency officials said such comparisons are like comparing "apples to oranges," because opiate addiction is distinct from other kinds of chemical dependency.

"What we rely on are national studies that have shown that methadone therapy is the best practice in health care," said Maureen O'Connell, assistant commissioner for chemical and mental health services.

Methadone works by occupying the same brain receptors affected by opiates, blocking the "highs" and "lows" and relieving the craving and withdrawal symptoms for those drugs, according to the U.S. Centers for Disease Control and Prevention. When given in stable doses, the synthetic opiate shouldn't cause highs or lows of its own, so it allows patients to work and function normally in society.

But if abused in large doses, methadone can produce a high, and the body rids itself of the drug relatively slowly, thus increasing the risk that a user will pile dose upon dose in search of a high and wind up dead.

"People do die from it, even in treatment programs," said Nick Reuter, public health analyst for the Substance Abuse and Mental Health Services Agency.

Terence Kall was one of those people. He hurt his back at work in 2003 and was prescribed Oxycontin for the pain. He became addicted and sought narcotics on the streets to fulfill his need, said his father, Joe Kall.

In 2006, Terence Kall enrolled at a Duluth treatment center and, with assistance from taxpayer-funded state health insurance, replaced his addiction to painkillers with an addiction to methadone. He died in 2010 at age 42 from a methadone overdose. Medical records show that methadone was the only drug in his system. Police recovered five bottles of methadone from his home, including one that was three-quarters empty.

"I know he wanted to get off of the drug, but he was afraid to," his father said. "The last two years he was walking around like a zombie. He spoke in bullet phrases. He acted like he was drunk."

Supporters of methadone treatment say many of the deaths aren't of people undergoing treatment for addiction but of people prescribed methadone for pain as a cheap alternative to other narcotics such as Oxycontin.

The majority of people in Minnesota who have died from methadone-involved overdoses have other drugs in their system, ranging from other opiates to sedatives to cocaine and alcohol, records show.

"What we're seeing is that people who use methadone to treat opiate addiction are consistently using street drugs to supplement that addiction as well," said Duluth police Sgt. Rodney Wilson, who works with the Lake Superior Drug and Gang Task Force.

Information from: Duluth News Tribune