methadone accounts for less than 10 percent of the drugs prescribed — but more than half of the deaths...
Who didn’t see this coming ?
Murder by the state
As a pain management specialist, I haven’t used methadone on a patient since around 2000. Methadone has a lot of attractive properties such as its NMDA blocking ability which is unique among opioids. But it has serious drawbacks such as a long 72 hr half life and potential for heart rhythm ( long QT interval) disturbances especially in combination with cardiac, anti-neuropathic, anti-depressant drugs. Couple this with the fact that many opioid dependent patients with chronic pain do not disclose other sedatives and narcotics they receive from other sources (doctor shopping, ‘friends’) and you have a recipe for disaster. I know this because methadone and other drugs (which I do not prescribe) often show up in the urine screens. I warn patients about this all the time. But it gets even better. Medicare has drastically reduced payment for urine drug testing, so doctors will be less likely to do these tests in the office to see if their patients have any dangerous interactions( methadone with sedatives and opioids for example).
Methadone should be limited to controlled environments such as hospices and hospitals where clinicians can control for drug interactions.