×

Welcome to the Slashdot Beta site -- learn more here. Use the link in the footer or click here to return to the Classic version of Slashdot.

Thank you!

Before you choose to head back to the Classic look of the site, we'd appreciate it if you share your thoughts on the Beta; your feedback is what drives our ongoing development.

Beta is different and we value you taking the time to try it out. Please take a look at the changes we've made in Beta and  learn more about it. Thanks for reading, and for making the site better!

The Painkiller That Saves Money But Costs Lives

timothy posted more than 2 years ago | from the while-poppies-burn-in-afghanistan dept.

Medicine 385

Hugh Pickens writes "Over 2,000 patients have died since 2003 in Washington State alone by accidentally overdosing on a commonly prescribed narcotic painkiller that costs less than a dollar a dose and the deaths are clustered predominately in places with lower incomes because Washington state has steered people with state-subsidized health care — Medicaid patients, injured workers and state employees — to methadone because the drug is cheap. Methadone belongs to a class of narcotic painkillers, called opioids, that includes OxyContin, fentanyl and morphine. Within that group, methadone accounts for less than 10 percent of the drugs prescribed — but more than half of the deaths and although Methadone works wonders for some patients, relieving chronic pain from throbbing backs to inflamed joints, the drug's unique properties make it unforgiving and sometimes lethal. 'Most painkillers, such as OxyContin, dissipate from the body within hours. Methadone can linger for days, pooling to a toxic reservoir that depresses the respiratory system,' write Michael J. Berens and Ken Armstrong. 'With little warning, patients fall asleep and don't wake up. Doctors call it the silent death.'"

cancel ×
This is a preview of your comment

No Comment Title Entered

Anonymous Coward 1 minute ago

No Comment Entered

385 comments

it is harder to get high on (5, Insightful)

Anonymous Coward | more than 2 years ago | (#38415742)

because of the way it works, junkies don't prefer it. so who cares if a bunch of people die needlessly, at least it prevents people from getting high. the drug war matters more.

Re:it is harder to get high on (5, Interesting)

Anonymous Coward | more than 2 years ago | (#38415758)

Wait: You use it as a painkiller? Why do you do that? It's almost the worst opioid you could possibly use for that!

There is no way that methadone should be used for anything other than treating opioid addiction.

Re:it is harder to get high on (0)

Anonymous Coward | more than 2 years ago | (#38415906)

It's hard to get high on? Are you being serious right now? Methone is super strong, and doesn't have much of a ceiling effect either. It shouldn't be used for addiction anymore either. We need to make buprenorphine cheaper and call it a day. Buprenorphine is a lot safer and has a better rate of helping people.

Re:it is harder to get high on (2)

Eunuchswear (210685) | more than 2 years ago | (#38416186)

Why not use diamorphine?

Re:it is harder to get high on (4, Informative)

blockhouse (42351) | more than 2 years ago | (#38416240)

Why not use diamorphine?

Too short of a duration of action. The purpose of using morphine as a replacement for OxyContin is because it's long acting, providing analgesia throughout the day. Diamorphine has a short, intense onset (which is why it's so addictive) and a similarly rapid cessation.

The current regulatory environment in the US, where diamorphine is Schedule I, may also have something to do with it.

(For those who are less pharmaceutically inclined, diamorphine = heroin.)

Re:it is harder to get high on (5, Funny)

dotancohen (1015143) | more than 2 years ago | (#38416358)

(For those who are less pharmaceutically inclined, diamorphine = heroin.)

(For those who are more C++98 inclined, diamorphine == heroin.)

Re:it is harder to get high on (1)

Eunuchswear (210685) | more than 2 years ago | (#38416410)

Why not use diamorphine?

Too short of a duration of action. The purpose of using morphine as a replacement for OxyContin is because it's long acting, providing analgesia throughout the day. Diamorphine has a short, intense onset (which is why it's so addictive) and a similarly rapid cessation.

Interesting.

My mum said it was great stuff, but she was in hospital and could get a hit when she wanted by pressing the button.

Would have been harder to do at home I suppose.

Re:it is harder to get high on (1)

sleigher (961421) | more than 2 years ago | (#38416284)

The generic version of Subutex is available, but the doctors don't like to prescribe because it can be abused. I don't believe there is a generic form of Suboxone. Suboxone is given to addicts because it is mixed with Naloxone. Naloxone is an antagonist and blocks or reverses the effects of opioids. Get a generic version of that to market and get rid of methadone. Methadone is worse than heroin. As hard or harder to kick. They can just manage your addiction with it better. I don't believe they want people getting off of opiates. They just want to manage your addiction.

I might be wrong about the generic form of Suboxone, but I have not heard of it on the market yet. Only Subutex.

Re:it is harder to get high on (5, Informative)

Anonymous Coward | more than 2 years ago | (#38416022)

It's prescribed as a painkiller more often than as a treatment. I'm a pharmacist and I go through methadone like mad and not on the prescriptions I fill is for addicition. I spoke to a pain doctor once who told me it was a cheaper alternative to OxyContin, which can run $600/month without insurance. Methadone runs about $30 a month without.

Some patients with insurance won't take OxyContin because their copay is high.

Re:it is harder to get high on (4, Informative)

blockhouse (42351) | more than 2 years ago | (#38416328)

It's prescribed as a painkiller more often than as a treatment. I'm a pharmacist and I go through methadone like mad and not on the prescriptions I fill is for addicition.

That's because in order to use methadone to maintain addiction, both the prescriber and the dispensing pharmacy have to be specially licensed. I've never heard of a chain or independent community pharmacy licensed as such. Methadone clinics usually have the prescribers and the dispensary at the same site.

Suboxone and the other buprenorphine-containing compounds have similar restrictions on the prescribers but not on the dispensing pharmacies. That's why you see DEA numbers starting with X on Suboxone scripts . . . it means the prescriber has been specifically licensed to manage opioid dependency.

Re:it is harder to get high on (0)

Anonymous Coward | more than 2 years ago | (#38416346)

a friend who is on methadone maintenance told me that doctors aren't allowed (in michigan, at least) to prescribe methadone for opiate addiction, that use must be covered by a methadone clinic. presumably because of monitoring issues.

The Republican Face of Future Medecine... (3, Insightful)

Anonymous Coward | more than 2 years ago | (#38416048)

...is more of this. Republicans want to turn Medicaid into a block grant program to states, with eroding value because payments won't keep up with inflation. States, squeezed to do more with less, will continue to do the cheap thing instead of the right thing for the poorest, most vulnerable (those with no cash to buy influence), and the poor will suffer and die in a greater and growing proportion to the rest of us.
 
They'll do the same thing to Medicare. So keep it up, poor and middle class, keep voting directly against your own economic interests, and watch your mortality rates soar.

Both Major Parties' Face of Future Medicine... (5, Insightful)

SteveFoerster (136027) | more than 2 years ago | (#38416216)

Washington State is controlled by Democrats. The majority of both houses of the legislature there are Democrats, as is the current governor and the last two governors before her. I expect, though, that you're too busy hating Republicans to recognize the Democrats are no different.

Re:it is harder to get high on (5, Interesting)

Anonymous Coward | more than 2 years ago | (#38416180)

I disagree entirely. You have to select patients very carefully, but it works wonders on some. I'm a pharmacy resident at a mid-sized hospital, and I did a pain consult on a patient who was sedated and intubated in the ICU. Poor nurse was out of her mind giving him Dilaudid shots every 30 minutes so he wouldn't spike his BP and breathe against the ventilator (both signs of inadequate pain control). Wanted to give him a longer acting opioid for basal pain control. Can't use OxyContin or MSContin here cause you can't crush it to put it in a feeding tube. Guy was also morbidly obese so it would take several days for a Duragesic patch to saturate all the subcutaneous binding sites. Methadone turned out to be the perfect answer.

Obviously you have to be extremely careful, but I don't have a problem with using methadone so long as the patient has good renal function, good hepatic function, good respiratory function (or a protected airway) and isn't taking any drugs that lengthen the QTc interval. This tends to rule out your older, sicker patients, and I suspect that most of the deaths from methadone toxicity happens in them.

In the case specifically addressed in TFA, the fact that the patient was on both methadone and Oxy simultaneously is mind-boggling. Especially in the setting of sleep apnea. More blame rests on the prescriber than on the drug.

methadone is very useful in managing chronic pain (5, Informative)

ridgecritter (934252) | more than 2 years ago | (#38416402)

Methadone's pharmacokinetics give it a long half-life, and therefore a long duration of action. This is an asset in managing chronic pain from cancer and some other diseases. Methadone has much less tendency to lose its analgesic effect through habituation. Morphine, for example, while an effective pain reliever due to its action on the mu-opioid receptor, has a metabolite that acutally upregulates perception of pain due to action on the NMDA system. This latter effect probably accounts for most of the often-observed dose escalation needed to maintain effective analgesia in patients treated with morphine. The primary danger of methadone is that physicians who are unaware of its comparitively slow pharmacokinetics overdose their patients because they escalate the dose too fast. It is critical to make changes (either increase or decrease) in methadone dosage *slowly* - when that is done, the drug can provide chronic pain relief with a much better combination of safety and long-term effectiveness than many of the other opiates. As always, ignorance seems to be the most deadly disease.

It even has its own tribute band (0)

hessian (467078) | more than 2 years ago | (#38415748)

Methadrone, noise/drone/post-rock with a metal soul.

http://www.myspace.com/methadrone [myspace.com]

Re:It even has its own tribute band (1)

Trepidity (597) | more than 2 years ago | (#38415912)

I think that has to do more with its use as a heroin replacement for addicts than its use as a painkiller...

Cynicism (-1)

Anonymous Coward | more than 2 years ago | (#38415776)

Does Methadone's patents happen to be running out, perchance?

Re:Cynicism (4, Informative)

Pharmboy (216950) | more than 2 years ago | (#38415806)

No perchance, and it was idiotic to even say, since you have easily looked it up and see that its protection was basically stripped from a defeated Germany in 1947. Wikipedia is your friend, laziness is not.

Re:Cynicism (1)

myowntrueself (607117) | more than 2 years ago | (#38416058)

I heard that the Nazis developed methadone because they wanted a pain killer that wouldn't be as addictive as other opiates.

They figured that if they made the side effects sufficiently horrible, people wouldn't get addicted to it.

How wrong they were...

Re:Cynicism (0)

antifoidulus (807088) | more than 2 years ago | (#38415818)

Congrats, you're an idiot. You obviously didn't even bother to read the first fucking sentence of the article, saves MONEY but costs lives. IE the drug is really cheap and not patented, and surprise! It isn't. Actually a lot of drugs in the list(all but oxycontin, and thats sort of up in the air right now, and will be expiring soon anyway). But don't let facts get in the way of your vapid statement.

Re:Cynicism (0)

Anonymous Coward | more than 2 years ago | (#38416008)

Love how everyone jumped on this calling the poster an idiot. Perhaps it was a legit question. I would question his wisdom of asking slashdot for any reliable information but to blast him/her as lazy and stupid for asking a question where you can't tell the tone shows what's wrong with internet forums in general and slashdot in particular.

Nice (-1, Offtopic)

beautyforblog (2534410) | more than 2 years ago | (#38415778)

Yes, one put I was at there were 10x the hold up staff per Windows desktop compare to the Sun workstations. from time to time I was the *only* Sun support guy for over 500 machines, which was pretty firm work but do-able. Actually, they were so low key that an audit discovered 100 or so Suns that we had forgotten about and that were doing their job just fine! (This was a long occasion ago..

BeautyforBlog
http://www.ontaheen.com

Re:Nice (0, Insightful)

Anonymous Coward | more than 2 years ago | (#38415804)

And this is exactly why having registered commenters score +1 just for posting is so wrong. Meanwhile, on-topic posts by ACs go unnoticed and will get repeated by registered users.

And no, we will not register unless there comes a time when other users cannot ban you for what you say.

So back to the topic... Doctors are idiots, law enforcement is corrupt and evil and pharmacists are complicit. This is what you get.

Re:Nice (0)

Anonymous Coward | more than 2 years ago | (#38416202)

And no, we will not register unless there comes a time when other users cannot ban you for what you say.

You can't be banned for what you say, otherwise we'd have rid ourselves of cunts like this one [slashdot.org] ages ago.

Makes sense now (0, Interesting)

Anonymous Coward | more than 2 years ago | (#38415788)

So that's why they were handing methadone out to Occupy protesters in my town. "Maybe they will fall 'asleep' in the park so we can get them out easy."

Re:Makes sense now (0)

Richard Dick Head (803293) | more than 2 years ago | (#38416148)

Yeah, welcome to this century's version of the world's oldest cost-cutting tactic.

"people with state-subsidized health care - Medicaid patients, injured workers and state employees"

And nothing of value was lost....

Note to Self: I'm getting the hell out of this country when I retire

This is ridiculous (5, Insightful)

Dunbal (464142) | more than 2 years ago | (#38415812)

As little as 100 years ago people were using perfectly legal opium compounds such as paregoric, with little or no social problems. The fact that people are dying and people are having their lives ruined by this failed "war on drugs" and the solutions are even worse than the problem just goes to show that government has no clue what it's doing.

Re:This is ridiculous (0)

Zironic (1112127) | more than 2 years ago | (#38415830)

What are you on about? The story is about the fact that people use the Opiod Methadone over other Opiods for painkiller use because it's cheap. However it is vastly more lethal then the other Opiods.

Re:This is ridiculous (5, Insightful)

swb (14022) | more than 2 years ago | (#38415924)

I'd wager cost has nothing to do with it and that they're being prescribed methadone over Oxycontin because of the reputation Oxycontin has, and the doctors don't want to be associated with Oxycontin.

And it's not that Oxycontin is a 'bad' medication, but it's gotten caught up in our moralistic, war on drugs mindset.

Re:This is ridiculous (1)

Zironic (1112127) | more than 2 years ago | (#38415958)

Well, the point of the article was that it was only Medicaid that was putting people on Methadone after putting it on the 'preferred drugs' list, implying that it is an 'equally safe' drug against all evidence to the contrary.

Meanwhile those with private insurance still get prescribed the more expensive Oxycontin.

Re:This is ridiculous (1)

joebagodonuts (561066) | more than 2 years ago | (#38416154)

And it's not that Oxycontin is a 'bad' medication, but it's gotten caught up in our moralistic, war on drugs mindset.

And methadone hasn't? I know it isn't what the cool kids are using, but methadone has been on the naughty list for awhile.

BTW, it isn't our moralistic, war on drugs mindset. You can claim it if you wish, I prefer not to.

Re:This is ridiculous (5, Interesting)

Anonymous Coward | more than 2 years ago | (#38416266)

I have to post anonymously about this, as well as leave out some details due to a settlement I got because of the mess you describe.

I have a problem with chronic kidney stones. My PCP eventually sent me to a pain clinic, where a doctor evaluated my current meds, my current needs, etc. I got a prescription for Oxycontin. Upon trying to fill this prescription, there were only two pharmacies that could fill it (several manufacturers were shut down due to illegal selling/distribution). One was at the pain clinic where I got the script, and the other was at CVS where I always filled all of my other prescriptions. The pharmacist was way way way beyond rude and pretty much called me a junky. I was absolutely furious. This man has made an extreme judgement of who I was because of my need for a powerful painkiller.

I come to find out this particular person owns http://banoxycontin.com/ [banoxycontin.com]. It was obvious this person had an agenda and I was just one of his targets to push it. I can't get anymore into the resolution of the situation, but rest assured I won.

The "war on drugs" causes shit like this. It ends up just being a witch hunt and there are too many innocents that end up burning

Re:This is ridiculous (2)

hairyfeet (841228) | more than 2 years ago | (#38415986)

Well if all they care about is cheap, why aren't they using morphine? Morphine is old as dirt so I seriously doubt there are patents for plain old morphine anymore, they have a version called MS Contin which is just a timed release formula, and if you are in pain MS Contin doesn't get you high it just blocks the pain. I have a relative that's been on it something like 25 years after a horrific car wreck messed his back and knees all up and the guy has been on the same dose all this time, never more, never less. Hell he even lives on the second floor of an apt building now and I honestly thought he'd be lucky to dress himself after the wreck.

So if all they care about is cheap they should just use the natural stuff. Frankly the artificial drugs we cook up always seem to do more damage than the natural compounds and its obvious from TFA that this Methadone may be cheap but its also nasty.

Re:This is ridiculous (1)

Eunuchswear (210685) | more than 2 years ago | (#38416230)

Well if all they care about is cheap, why aren't they using morphine? Morphine is old as dirt so I seriously doubt there are patents for plain old morphine anymore,

Is the world opium shortage over?

Re:This is ridiculous (1)

Type44Q (1233630) | more than 2 years ago | (#38416302)

...just goes to show that government has no clue what it's doing

Perhaps not but rest assured, the select few above them most certainly know what they're doing. You could even argue that they're doing a damn good job of it...

Accidental overdose? (1, Funny)

loufoque (1400831) | more than 2 years ago | (#38415826)

How can you accidently take more than the prescribed amount?
Can't decipher the doctor handwriting?

Re:Accidental overdose? (5, Informative)

Zironic (1112127) | more than 2 years ago | (#38415838)

Overdose isn't when you take more then prescribed, it's when you take more then what your body can handle.

As such most overdoses are accidental.

Re:Accidental overdose? (0)

loufoque (1400831) | more than 2 years ago | (#38415864)

If the doctor prescribed more than your body can handle, then the problem is with the doctor, not the drug.

Re:Accidental overdose? (3, Insightful)

Zironic (1112127) | more than 2 years ago | (#38415878)

As far as I know, usually what happens is that while the drug is strong, it's not effective in treating chronic pain because the effectiveness is erratic.

The patient will then take more of the drug, because they think that their dose is too low since it's not being effective, thus ending up overdosing themselves.

Re:Accidental overdose? (1)

Anonymous Coward | more than 2 years ago | (#38415940)

It may not be intentional, but damn. I hate it when people think they're so smart and think it's OK to go above prescription. Instructions are often there for good reason, if its not cutting the problem, its better to go to the physician again.

Re:Accidental overdose? (2)

Anne Thwacks (531696) | more than 2 years ago | (#38415968)

I think you will find there is no law against stupidity. In fact, the truly stupid get an award named after a famous scientist - its called the "Darwin Award".

Re:Accidental overdose? (-1)

Lumpy (12016) | more than 2 years ago | (#38416054)

In civilized countries where you have health care? I agree.

Here in the USA that does not happen. Insurance is garbage so we have to pay the doctor another $250-$300 for a visit to talk to him about the dosage.

Doctors are overpaid, drugs are criminally expensive and insurance is garbage all because a bunch of assholes in the 1% whined about universal healthcare. We hate the poor and working class here in the USA so we make sure that proper medical care is out of reach.

Bring on the doctor blame.... (5, Insightful)

RobinEggs (1453925) | more than 2 years ago | (#38416378)

Doctors are overpaid

Can we please stop this shit? Blaming doctors doesn't help you, and they are generally not overpaid. For the length and stress of their training, the debt they incur, and the difficult lifestyle many specialties must endure permanently, most doctors are actually underpaid - in overall salary, in compensation per hour, or both.

I know primary care physicians who've been forced quit the business after 30 years and had to go work somewhere else. How does a doctor who can't afford to be a doctor, and doesn't have enough savings to retire after 30 years, fit with your ignorant screed that doctors are overpaid?

I also know surgeons, many of whom do make $300,000 a year, and I've never seen one of them sit still for more than 15 minutes, to watch a movie or lecture, without passing out. They work a minimum of 60 hours a week and constantly get paged for surgery in the middle of the night, whether or not they're actually 'on call'.

So many types of doctor make so little that people are quitting left and right, while med students refuse to even consider the specialty, and many other types work so many hours with such a poor quality of life that their compensation per hour (not to mention per 3 am emergency call) makes engineering and business look like much better careers.

Many doctors are underpaid; many others are overpaid but massively overworked and overstressed. The cross-section of doctors who are both overpaid and live comfortable lifestyles is much, much smaller than you think.

Re:Bring on the doctor blame.... (0)

khallow (566160) | more than 2 years ago | (#38416406)

For the length and stress of their training, the debt they incur, and the difficult lifestyle many specialties must endure permanently, most doctors are actually underpaid - in overall salary, in compensation per hour, or both.

I have no trouble both underpaying them more and reducing the onerous training requirements for being a doctor.

Re:Accidental overdose? (0)

Anonymous Coward | more than 2 years ago | (#38415966)

It's an overdose in both cases, and it can also be accidental in the former case.

Re:Accidental overdose? (1)

thue (121682) | more than 2 years ago | (#38416018)

> Overdose isn't when you take more then prescribed, it's when you take more then what your body can handle.

According to Wikipedia [wikipedia.org], an overdose "describes the ingestion or application of a drug or other substance in quantities greater than are recommended[1] or generally practiced.[2]"

So your use of the word is incorrect.

Re:Accidental overdose? (1)

blockhouse (42351) | more than 2 years ago | (#38416384)

> According to Wikipedia [wikipedia.org], an overdose "describes the ingestion or application of a drug or other substance in quantities greater than are recommended[1] or generally practiced.[2]"

So your use of the word is incorrect.

We don't recommend "ingestion or application of a drug or other substance" in quantities greater than what your body can handle, so therefore taking more drug that the body can handle is, in fact, overdose.

Seriously, you're going to bicker over semantics?

I know, I know, I must be new here, etc. etc.

Re:Accidental overdose? (1)

Ihmhi (1206036) | more than 2 years ago | (#38416066)

Aren't most doses measured by body weight? A 100 lb. woman taking four tylenol would be more affected than a 200 lb. woman. Perhaps a decent medical regulation would be factoring in whatever metrics are needed before dosing.

It would also solve a few problems. I'm a rather large guy (definitely vertically, and a fair bit horizontally). A "normal" dose of Nyquil might make me a wee bit drowsy. A double dose will put me out. If they had weight ranges (or whatever the dosing factor might be), then maybe people would stop ODing because they take too much of something on account of the prescibed dose not doing crap for them.

Re:Accidental overdose? (1)

pz (113803) | more than 2 years ago | (#38416172)

I am not a doctor, and this is not medical advice.

A proper, correct dose (total amount) of drug is determined by the dosage (amount per body weight) and the weight of the individual. It also should account for individual variations in sensitivity.

Mostly, to save time, doses are determined by multiplying the dosage by an average body weight. For most drugs, which have a very broad dose / response curve, and thus a wide range of therapeutically useful values, that's fine. For some drugs, you have to be more careful.

My wife (yes, this geek got lucky) is quite small, and thus nominally takes about 1/2 of prescribed doses (to be entirely accurate, she should be taking about 2/3, but most drugs have a broad dose / response curve, and 1/2 a pill is easier to create than 2/3 of a pill). I'm about average weight, and so the nominal doses typically work fine for me. Over-the-counter drugs have doses (again, total amount) based on a 170 lb body weight; it's pretty easy to normalize by 170 to get the dosage (again, amount per body weight) and multiply by your weight to get a more accurate dose. If you weigh anything close to 170 lbs, it isn't worth the effort.

This is not medical advice, I am not a doctor, and you should take the preceeding only as interesting information. What you do with it, and any consequences, are entirely your responsibility.

Re:Accidental overdose? (1)

Rich0 (548339) | more than 2 years ago | (#38416428)

Well, you're describing what you do - but most doctors prescribe whatever the product circular tells them to, and most people take what is prescribed. If you're in a hospital they'll refuse to give it to you most likely if you won't take it as prescribed.

However, in terms of the dosage that is most likely to work for you, the chemistry works more-or-less as you describe. Weight should almost always be a considerating when prescribing medication.

The problem is that many drugs are only available in a few potencies, and most clinical trial data is just the average across the population at each potency. Maybe the manufacturer has more data on a mg/kg basis, but I doubt doctors have access to it.

My own wife is small and takes many medications - it is a bit of an empirical thing but I'm fairly confident that on average she gets prescribed more than she really needs. Prescription practices are based as much on tradition as science, except maybe if you're talking about chemotherapy or something like that.

Oh, and body weight isn't necessarily the best indicator of dosing. I'm not an expert, but I'd think that you'd also need to consider how the drug is partitioned in the body - if it is more lipid-soluble then body fat might matter more, and so on. As we all learned in physical chemistry chemicals distribute themselves in equilibrium between various phases as governed by their partition coefficients (once everything reaches steady state). Since drugs are engineered to target particular tissues/etc, I'd think that they'd be more sensitive to this than most. If the dissociation constant with its target is low enough, then binding might be near-stoichiometric so dosing might be based more on the total mass of the target in the body, and some organs don't scale with weight so much.

And again, I'm not an expert in such things - I just know a little chemistry...

Re:Accidental overdose? (2, Interesting)

Anonymous Coward | more than 2 years ago | (#38415852)

Easily. How can you accidentally do anything?

Re:Accidental overdose? (4, Interesting)

HeLLFiRe1151 (743468) | more than 2 years ago | (#38415938)

Ritalin used to be the same size and color as methadone until one pharmacist accidentally put Methadone in some kids prescription of Ritalin. No one could figure out what was wrong with the kid, even as far as making the kid take more of it. The kid died. That's how you accidentally overdose.

Re:Accidental overdose? (1)

AndroSyn (89960) | more than 2 years ago | (#38416012)

No one could figure out what was wrong with the kid, even as far as making the kid take more of it. The kid died. That's how you accidentally overdose.

[citation needed]

Re:Accidental overdose? (1, Informative)

Anonymous Coward | more than 2 years ago | (#38416116)

Here you go, slothbag;

http://www.pharmacy-mistake.com/eight-year-old-sickened-after-pharmacy-refills-prescription-with-methadone-instead-of-ritalin
http://www.wate.com/Global/story.asp?S=3580654

That took 30 seconds. Maybe you could have helpfully posted it yourself in about the same length of time it took to be a prick about it. And being wrong in your implication that it was false.
 
Asshole.

Re:Accidental overdose? (2, Informative)

Anonymous Coward | more than 2 years ago | (#38416190)

You said the kid died. Nobody died.

Re:Accidental overdose? (0)

Anonymous Coward | more than 2 years ago | (#38416268)

Asshole.

Re:Accidental overdose? (0)

Anonymous Coward | more than 2 years ago | (#38416292)

u mad bro?

Re:Accidental overdose? (3, Insightful)

syousef (465911) | more than 2 years ago | (#38415870)

How can you accidently take more than the prescribed amount?
Can't decipher the doctor handwriting?

Forget you've taken it and take it again. Anyone can become distracted but the very old (prone to memory related illnesses) and very young (in the care of others) are particularly susceptible.

Re:Accidental overdose? (2)

moortak (1273582) | more than 2 years ago | (#38415978)

Or perhaps people people on high doses of opiates. My wife was on a very heavy dose of Oxycontin for a long time and there were more than a few occasions wherre she wasn't sure if she taken her pills yet. We always played it safe and held off when there was doubt, but there were a few occasions where I had to stop her because she was sure she hadn't taken it. Large doses of these rugs don't exactly leave you clear headed.

Re:Accidental overdose? (4, Insightful)

Lumpy (12016) | more than 2 years ago | (#38416074)

You've never been in serious pain then.

Even a perfect health 20 year old in a scale of 1 to 10, a 10 in pain will not only forget they took a painkiller, but will want the pain to subside so badly that taking another one is certainly a thought process they go through.

Stick a railroad spike in your head and then pour salt and lime juice on it. Then tell me you will sit there and remember you took a pain pill 30 minutes ago.

Re:Accidental overdose? (4, Insightful)

GreatBunzinni (642500) | more than 2 years ago | (#38415898)

From the article, it sounds like this is not a problem caused by cheap drugs but by piss-poor medical care. If a patient is given a specific form of Opioid which is known for stuff such as 'With little warning, patients fall asleep and don't wake up", and it does so frequently that they even gave this form of death the pet nickname, "silent death", then it does look like the only problem is that patients aren't monitored accordingly. To put it in other words, it does sound like they are putting the blame on a drug for a problem which is caused by incompetent medical staff which are routinely slacking off monitoring their patients and doing their rounds. Giving poor people sub-standard health care to the point of being considered neglect is a much more serious problem than providing cheap drugs.

Re:Accidental overdose? (1)

Zironic (1112127) | more than 2 years ago | (#38415926)

Huh? This is about pain medication that you're prescribed, not the pain medication you get while at the hospital (which tends to be mostly injected Morphine afaik).

Possible FRAUD Alert (4, Informative)

Futurepower(R) (558542) | more than 2 years ago | (#38415832)

I don't think I know anyone who takes pain drugs, so I have no personal knowledge. However, I found a short article about Methadone on the Seattle Times web site recently when I was looking at Google Health news. Even the summary seemed obviously suspicious, so I looked at the article.

To me, that article and all the data to which the Slashdot story linked screamed incompetence or fraud. Now that I've read a little of the linked data, I realize the writers are at least partly incompetent. Possibly only whoever started them looking was engaged in fraud to sell more expensive drugs.

I just discovered that I'm not the only one who thinks that. [nwsource.com] Short quotes, read the full comments:

"It does not matter if you switch every body to oxycontin or oxycodone. These drugs are terrible at controlling pain and all are very dangerous."

"... I have an issue with how the Seattle Times is drawing a correlation between poverty and methadone poisoning. ..."

Possibly Methadone is more often given to people who have little education, and who are therefore more likely to overdose because they didn't understand the instructions, or because they have other issues that confuse them.

Do you have poor reading comprehension? (2)

arcite (661011) | more than 2 years ago | (#38415942)

The key point of the linked article was not that those who were given the drug overdose because they have less education and cannot read the medical instructions, but that they are given the drug because it all they can afford given the status of their medicare. Poverty does not discriminate between those who are educated and those who are not. We shouldn't blame the victim, blame the doctors and the insurance companies.

Re:Do you have poor reading comprehension? (4, Informative)

Anne Thwacks (531696) | more than 2 years ago | (#38415996)

Poverty does not discriminate between those who are educated and those who are not.

Maybe not on your planet, but here on earth, educated people have a much better chance of making money, and people with money are likely to get a better education. People with poor reading skills, or other problems with communication are likely to be on very low incomes all their lives.

I acknowledge that educated people can be poor whether short or long term, but they are not the same boat at all.

Re:Do you have poor reading comprehension? (2, Informative)

Anonymous Coward | more than 2 years ago | (#38416204)

I just bought a 50-pack of Ibuprofen 600 for 5€ (the same price that every drug costs) and a 30-pack of Omeprazol for 0€ (unless it's free ;), thanks to my health insurance which is paid by a tax going off of my salary.
And if I lose my job, there is a government agency that pays for it no matter how long I'm without a job. (Yes, they push you into getting a job and send you job offers. But there is nothing wrong with that.)
I can go to the doctor or hospital as often as I want and I get what's necessary. It's not perfect, but for a couple of € more a month, I get premium healthcare.

Problem, America? :D

Re:Possible FRAUD Alert (0)

Anonymous Coward | more than 2 years ago | (#38415976)

In the comments you link to is evidence directly opposing your view that the article is a fraud. Especially since the first quote you picked is part of a larger comment that agrees with the article, not you.

The issue apparently is that Washington state has been pushing the use of methadone as a cheap alternative, but at the same time the group in charge of rating the safety of methadone has ignored serious flaws and issues when it says methadone is safe. Other opiates may not be much better for pain relief, but the government has been covering up the unique issues with methadone. Namely, that is has a longer half-life in the body which means it is easier to overdose on than other opiates.

Re:Possible FRAUD Alert (0)

Anonymous Coward | more than 2 years ago | (#38416262)

"It does not matter if you switch every body to oxycontin or
oxycodone. These drugs are terrible at controlling pain and all are very
dangerous."

Oxycontin IS oxycodone, so your quoted source is pretty weak on the face of it. Also, the notion that isn't good at pain... is just wrong. I can personally attest to it after nice long trip through chemo this year.

Is it cost, or painkiller paranoia? (5, Interesting)

swb (14022) | more than 2 years ago | (#38415834)

Doctors don't generally like to prescribe pain killers. They worry about addiction, they worry about the DEA auditing their prescribing habits and yanking their license, without which it's kind of hard to be a doctor.

When they prescribe methadone, is it really out of cost, or have they grown so fearful of prescribing Oxycontin that somehow methadone seems like a reasonable alternative? And how many of those fears are medical/pharmacological, and how many are "if I prescribe Oxycontin I'll get in trouble" or "gee, there's a lot of press about Oxycontin, I shouldn't prescribe it"?

Re:Is it cost, or painkiller paranoia? (5, Interesting)

Pharmboy (216950) | more than 2 years ago | (#38415900)

You raise a good point. I see a pain specialist because of tendon and back problems. Regular doctors are regularly audited, but pain specialists are super audited, and the DEA puts so much pressure on them, that they do NOT like to prescribe pain killers at all if they can help it. (Based on input from 3 different doctors here). They have to keep records beyond the norm, prove that other methods were tried first, etc. I had not had a physical last year, and he wouldn't re-up my prescription until I did. His reasons weren't my health, he flatly said that he could get in trouble. So now our national health policy is party "ruled" by the DEA, a bunch of fucking idiots with a faulty agenda and no real world experience in front line medicine....great.

Re:Is it cost, or painkiller paranoia? (3, Insightful)

swb (14022) | more than 2 years ago | (#38415948)

Worse than that, I don't even think the DEA applies medical logic -- I think their logic is all about drug control. They could care less about whether clinically effective medicine is taking place, they just want fewer painkillers in civilian hands.

Re:Is it cost, or painkiller paranoia? (2)

snowgirl (978879) | more than 2 years ago | (#38416086)

Apparently, my mileage varies greatly from others. I had a UTI, and they gave me a narcotic. No questions asked, just "here's a week's supply". And since I had 100% coverage, I didn't even give them any cash. It felt weird getting narcotics for just a signature, but there you go.

Later on, during recovery from some major surgery, I had my Oxycotin prescription renewed without question, or hassle for about 2 months (at one point, they later switched me to Vicodin, same stuff, just a higher Tylenol to narcotic ratio).

Although, I suppose in the surgical instances, no DEA agent is ever going to question why you're giving a patient narcotics after surgery... and then in the first case, I was peeing blood, so... probably no reason to expect to be hassled about that as well. Then of course, none of these three were for chronic pain, but rather for acute pain, that was expected to subside relatively quickly.

Come to think of it, after I had my big motorcycle crash, I think they gave me a short-term supply of narcotics as well, no questions asked. But then again, also not for chronic pain.

Meh, I don't know. I suppose what I'm saying is that I've never had trouble getting any narcotics. In fact, beyond the signing for it, I don't think I've ever had any more hassle getting narcotics than getting any other prescription drug. But then as noted, all of it was short-term, and none of it chronic. Likewise, all of them were well justified pain prescriptions.

Re:Is it cost, or painkiller paranoia? (3, Interesting)

sribe (304414) | more than 2 years ago | (#38416234)

When they prescribe methadone, is it really out of cost, or have they grown so fearful of prescribing Oxycontin that somehow methadone seems like a reasonable alternative? And how many of those fears are medical/pharmacological, and how many are "if I prescribe Oxycontin I'll get in trouble" or "gee, there's a lot of press about Oxycontin, I shouldn't prescribe it"?

Well, let me just tell you: I am not an "addictive personality" and have never had any problems whatsoever like that; I was on Oxy for 1 week after shoulder surgery, and wow; I actually went through (mild) withdrawal--headaches, night sweats, chills... Of course for me there was no temptation to get more to ease those symptoms, instead my reaction was "wow, I sure wouldn't want to take this shit any longer".

And oh yeah, I did feel really good on it, no question about that...

Well, pain killer, lol (1, Interesting)

Anonymous Coward | more than 2 years ago | (#38415848)

Actually here around it's better known as a "legal" (when given in the correct programme) substitution drug for heroine. (Basically instead of letting junkies do crimes to get their hand at illegal drugs, let's doctors prescribe it, with the official "goal" of getting the junkie some time in the far future clean).

And it's that narcotic, that you do not only need special prescriptions, nope, the drug is usually not given out to the "patient", they are forced to go in daily to the pharmacy and consume it on site.

One last thought, opiates are known to create very strong addictions, hence locally they are usually only administered in very restricted circumstances, e.g. as after care after surgery known to induce extreme pain, if really any other pain medication does not help, but only for a short term till the reasons can be fixed, and mostly for terminally ill patients (where the addiction aspect is irrelevant, but the painless sleep potentially into death is quite relevant).

Basically, cost accounting and medicine do not mash to well, and especially state run (but private insurances are not much better, but they tend to do it on a case by case base) systems have a tendency to go for cheap treatments even if they are not medically sound. (And using heavy addiction inducing drugs as a general pain killer medication is not sound policy). The only way (locally) to get them to do the right thing is usually to force the "cost controlling" MDs (it's always MDs here around that need to decide) to put their decision in writing including the reasoning, and mention that one needs this for the Social Court (locally we've got special courts for stuff related to social services and employment situations, and they usually tend to rule favorably), ... => more than once the MD reevaluated her decision while trying to formulate the reasoning.

Re:Well, pain killer, lol (-1)

Anonymous Coward | more than 2 years ago | (#38415946)

hey american you don't know shit about "state run" medicine, so shit your uneducated cunt face.

Re:Well, pain killer, lol (3, Insightful)

subreality (157447) | more than 2 years ago | (#38416002)

Basically instead of letting junkies do crimes to get their hand at illegal drugs, let's doctors prescribe it, with the official "goal" of getting the junkie some time in the far future clean).

And it works! If you give a junkie a reliable, free supply of opiates, they quit the cycle of binging then stealing things when they run out, are generally able to function in society, and gradually wean themselves off. It is more effective than any other treatment.

Methadone is particularly effective because for this because it's very long-acting. It doesn't provide a reward rush when you take it, and it doesn't crash fast leaving them desperately craving.

they are forced to go in daily to the pharmacy and consume it on site.

Sure. Heroin users are used to gauging their dose by the immediate response. Methadone is really slow, so they think they didn't take enough and take more, only to end up overdosing when it hits. For non-addiction prescriptions they just give you a 30-day supply.

And using heavy addiction inducing drugs as a general pain killer medication is not sound policy

What would you suggest for severe pain? Advil isn't going to do it.

Are these all really "accidents" . . . ? (2, Insightful)

PolygamousRanchKid (1290638) | more than 2 years ago | (#38415908)

. . . faced with a life full of incurable, chronic, unbearable pain . . . this "silent death" might seem like a more pleasant option for some folks.

It would seem like an alternative for a doctor forbidden by law from assisting a patient requesting euthanasia. The doctor prescribes the medication and describes the risks. It is the patient's choice to take a lethal amount.

I live with pain (5, Interesting)

Kilz (741999) | more than 2 years ago | (#38415910)

18 years ago I messed up my back, 8 years ago I did it again. The second time around didnt have the results of the first. I live with constant pain while awake unless laying down.
Pain is depressing, it ruins your attitude and life. I have learned to live with it, with pain pills to manage the pain. When sent to pain management every so often to get the pain medication adjusted methadone is always pushed, I am also low income. I have done a lot of study of pain drugs and will always tell the doctor that is one medication I want to avoid. At present I am on Percoset (oxycodone/acetaminophen). While it isnt as cheap as the methadone on my crappy insurance, my life is way more important than the $10 a month extra it costs me.
But the problem may not be the drug itself but the idea that some people in pain have that they can avoid pain completely. This isnt always the case when you are on these types of medication. You can control pain, you can moderate pain. But if you think that if I take a pill or two extra it will get rid of it altogether you are on a slippery slope. My brother tried that, he ended up taking more and more pills because over time your body starts resisting them. Thats where the danger lies. You take so many that you end up killing yourself by overdose, like my brother did at 36.

Waaaaa (-1)

Anonymous Coward | more than 2 years ago | (#38415974)

Sounds like possibly you just come from a family of worthless junkies. Or just really fucking tarded. "I messed up my back, then 10 years later I did the same thing because I am that fucking stupid I couldn't correlate with causation" maybe your brother was smart enough to put the rest of us out of our misery supporting the legally brain dead. But yep go ahead, help other worthless losers continue their self justification for existance.

Re:Waaaaa (1)

roman_mir (125474) | more than 2 years ago | (#38416156)

About 10 years ago my knees started hurting and they never stopped and I've been to doctors around the globe pretty much and nobody can identify why I have this pain. I tried a few types of medication and realized that I can't live my life on drugs, so I learned to live with the pain, I just learned not to pay attention. I tell you what, if you want to get your ass kicked by somebody who doesn't care about pain anymore, talk to me, I'll arrange it in a hurry.

Re:I live with pain (0)

Anonymous Coward | more than 2 years ago | (#38416024)

And experimenting with pain medication - with a doctor's help, of course - is extremely difficult because docs are afraid of getting into trouble. Yeah, War on Drugs.

And if you have a history of drug abuse - even if you were trying to self medicate (which is what all drug abuse is about anyway) - you're pretty much screwed with getting the help you need.

Medical Marijuana (0)

Anonymous Coward | more than 2 years ago | (#38416092)

To hell with the law. If you need medicine, there is no harm in trying. Even if you live in a "medical" state, don't ask for permission, just do it. It is your moral right.

It's called (-1)

Anonymous Coward | more than 2 years ago | (#38415932)

Euthanize the poor.

Re:It's called (0)

Anonymous Coward | more than 2 years ago | (#38416040)

or euthanize the people who find it easier to blame others for their lot in life than attempt to improve it. Yes thats right, it was a plot by a secret organization to keep you down, in order to further their fiendish goals.... dumbass

Heroin substitute. (1)

salparadyse (723684) | more than 2 years ago | (#38415994)

Here in the UK Methadone has been used as a heroin substitute for some years. It's considered to be more addictive than heroin but of predictable quality and supply, hence its use.
The glaringly obvious solution of the State control and supply of heroin to addicts is apparently beyond those who make such decisions. Far better to throw money up the wall buying a substitute and then pretend you're handing out medicine.

Re:Heroin substitute. (1)

myowntrueself (607117) | more than 2 years ago | (#38416068)

Here in the UK Methadone has been used as a heroin substitute for some years. It's considered to be more addictive than heroin but of predictable quality and supply, hence its use.

The glaringly obvious solution of the State control and supply of heroin to addicts is apparently beyond those who make such decisions. Far better to throw money up the wall buying a substitute and then pretend you're handing out medicine.

yeah and the side effects of methadone are supposed to be unpleasant enough to deter addiction. Well thats what the Nazis figured when they invented the stuff...

Re:Heroin substitute. (4, Interesting)

pla (258480) | more than 2 years ago | (#38416170)

We use it like that here in the US, but thanks to our Puritanical roots, we frequently see it used only "unofficially" in that capacity.

We have tons of rules regarding where methadone clinics can go, how many people they can serve, under what conditions people can use it, how long, etc. So you end up seeing a lot of methadone prescribed for "chronic pain", despite the fact that it really kinda sucks for the whole "pain management" thing that opiates normally excel at.

Really, it does one and only thing well - It keeps people from going into withdrawal.

So basically, when you see a cluster of poor minorities with loq education OD'ing on this stuff, it doesn't mean their doctors have failed, it means a not-quite-ex-addict tried to get high on it and learned the hard way that it doesn't work very well for that, either.

Re:Heroin substitute. (1)

Blue Stone (582566) | more than 2 years ago | (#38416320)

>Here in the UK Methadone has been used as a heroin substitute for some years. It's considered to be more addictive than heroin but of predictable quality and supply

Actually I don't think that's the issue - the predictable quality and supply - that's only an issue with illegal drugs - because of the dealers cutting them and drug prohibition endangering supply. If you gave the patient medical grade heroin or another opioid - they would also have predictable quality and supply.

I think the real reason they give methadone instead of heroin to addicts is that it doesn't give the user the same euphoric effect - it's a psychological-political issue - about the state of mind a government will allow people to experience - and this 'high' is seen as dangerous and forbidden.

Studies have proven elsewhere that regualr controlled presribing of heroin - under supervision- allows an addict the stability they need to sort their life out and return to a regualr family & work life - giving them the confidence to ditch the drug in their own time.

Methadone use for drug addicts is a perverse symptom of prohibition and polidical ideology that does more harm than good.

Re:Heroin substitute. (1)

Anonymous Coward | more than 2 years ago | (#38416430)

It's actually on cost and dosing grounds. Diamorphine costs the NHS up to £20,000 per year at doses used for opioid detox (because of the huge doses involved and multiple times per day usage) whereas methadone doesn't go over about £600.

So it's killing welfare recipients? (-1)

Anonymous Coward | more than 2 years ago | (#38416026)

Sounds Iike win win to me!

Re:So it's killing welfare recipients? (0)

Anonymous Coward | more than 2 years ago | (#38416142)

Ron Paul 2012!

Drugs == Accellerated Darwinism (0, Troll)

erroneus (253617) | more than 2 years ago | (#38416070)

They should allow people do do all the drugs they want. Give them a location on a rail right above a giant wood chipper so that when they do it to themselves, they also dispose of themselves in a way that could feed fish or fertilize a field somewhere.

Perhaps the 'defect' is with me though. I find the idea of putting a chemical into my body to induce a feeling to be stupid and unattractive. It would seem the majority of people are disagreement with me on this point. I guess when the end of the world comes about, some people will be easier to control and put down than others.

Not a valid study (0)

Anonymous Coward | more than 2 years ago | (#38416080)

Working in the medical field, I can say that the majority of people prescribed methadone are for Maintainance therapy of chronic narcotic users/abuses. As such this story makes no sense because the risk profile of this group is different that the general population and to compare the two is not valid.

We have money for bombs, but not people. (4, Interesting)

unity100 (970058) | more than 2 years ago | (#38416084)

And, what's more, there are pieces of shit who advocate even canceling what little we give to the unfortunate.

figures why the world is STILL deep in shit in godfrigging 21st century.

Methadone does more than save money (1)

sirwired (27582) | more than 2 years ago | (#38416120)

With a skilled doctor and a well-instructed patient, Methadone is a perfectly legitimate and normal Opioid pain reliever. The longer effects of the drug (vs. other options) mean the level in the bloodstream stays more level. Yes, if the patient cannot follow instructions, or the doctor is not aware of how Methadone is metabolized in the body, this can be harmful; there are tradeoffs with almost any drug. You can hardly blame the drug if the doctor ignores the prescribing information or the patient doesn't properly taper off of other painkillers while starting up the Methadone.

Sometimes (0)

Anonymous Coward | more than 2 years ago | (#38416226)

Death is a luxury.

I wish the world did respect the rights of patients to take risky medicines.

"silent death"...ha! (0)

Anonymous Coward | more than 2 years ago | (#38416232)

As a recovering addict, having had and seen my fair share of overdose...I can assure you that choking on your own tongue and/or vomit is very non-silent.

Load More Comments
Slashdot Account

Need an Account?

Forgot your password?

Don't worry, we never post anything without your permission.

Submission Text Formatting Tips

We support a small subset of HTML, namely these tags:

  • b
  • i
  • p
  • br
  • a
  • ol
  • ul
  • li
  • dl
  • dt
  • dd
  • em
  • strong
  • tt
  • blockquote
  • div
  • quote
  • ecode

"ecode" can be used for code snippets, for example:

<ecode>    while(1) { do_something(); } </ecode>
Sign up for Slashdot Newsletters
Create a Slashdot Account

Loading...