What is the Solution?

Posted on: February 8th, 2012 by
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Please Post Any Ideas You May have to Stop Methadone Deaths in Comment Section. (Note: These are not listed in order of Priority)

  1. The methadone clinics that are being run like “pill mills” need to be shut down. The doctors and clinic owners need to be prosecuted for these deaths. They are “legal” drug dealers. The agencies that could do somthing about this are not acting fast enough, if at all. (FDA, SAMHSA, DEA , STATE AGENCIES that are responsible for enforcing state and federal regulations and State Methadone Authorities) We need to contact them on a regular basis and force them to do their job. We pay their salary!
  2. Contact your Representative and ask them to co-sponsor HR672 or to suggest any ideas you may have.  Click HERE to contact.  This is the National Drug Control Strategy for 2012 from the White House-National Drug   Control Strategy 2012 Policy Focus: Preventing Prescription Drug Abuse begins on Page 47.
  3.  Pharmaceutical Companies need to pay for all cost for inpatient drug treatment (Abstinence Based) due to prescription drug addiction
  4. Require physcians to have training on prescribing opiates before they are assigned a DEA number.
  5.   METHADONE NEEDS A LABEL REVISION TO INCLUDE ADDICTION TREATMENT This not the solution but should have been included in the 2006 label revision. The excerpt  below is from the relabeling revision on methadone that was released by the FDA 11/17/2006. Please note that this addresses treatment for pain patients only and does not include treatment for addiction. It states deaths have been reported during initiation and conversion from chronic high dose opioid agonists. Most methadone deaths from treatment of addiction occur during the first two weeks of “treatment”.The label needs to be revised to include treatment for opiate addiction. Opiate addicts are being converted for high dose opioid agonists to methadone also.

Methadone Hydrochloride Tablets 5mg, 10mg

WARNINGS:

“Deaths, Cardiac and Respiratory have been reported during initiation and conversion of pain patients to methadone treatment from other treatment with opioid agonists.”

“Respiratory Depression, Incomplete Cross-tolerance, and Iatrogenic Overdose Respiratory depression is the chief hazard associated with methadone hydrochloride administration. Methadone’s peak respiratory depressant effects typically occur later, and persist longer than its peak analgesic effects, particularly during the initial dosing period. These characteristics can contribute to cases of iatrogenic overdose, particularly during treatment initiation or dose titration. Patients tolerant to other opioids may be incompletely tolerant to methadone. Incomplete cross-tolerance is of particular concern for patients tolerant to other mu-opioid agonists who are being converted to treatment with methadone, thus making determination of dosing during opioid treatment conversion complex. Deaths have been reported during conversion from chronic, high-dose treatment with other opioid agonists. Therefore, it is critical to understand the pharmacokinetics of methadone when converting patients from other opioids (There are no safe conversion tables when converting a patient from another Opioid to Methadone). A high degree of “opioid tolerance” does not eliminate the possibility of methadone overdose, iatrogenic or otherwise.”

 

The following are some suggestions that I have to help reduce Methadone Deaths In MMT:

  • Required training for all medical personal with testing on material learned and that will be verified (maybe SAMHSA can keep records) STRESS all the deaths that have occurred with methadone.

 

  •  Required training of patient with a video that stresses all the DEATHS  that have occurred with methadone, The  risk of use of ANY medication with Methadone and the high chance of death during the induction phase. Inform patient of risk of sudden cardiac death and advise patient they may want to have a full cardiac workup before beginning drug. Give patient examples and statistics of DEATHS.

 

  • Since inpatient induction would not be cost effective but would be safer, require patient to have family monitor patient for signs and symptoms of overdose during the first two weeks of induction. STRESS the fact patient may go to sleep and not wake up!

 

  •  Send patient home with emergency narcan and train family members how to administer

 

  •  Strict guidelines for determining opiate tolerance of patients.

 

  •  Set a safe guideline for doctors concerning induction. Advise doctors of a correct safe low dose to start medication instead of just listing a maximum dose of 30 mg which is not safe for opiate naive persons or some opiate tolerant persons.

 

  • Do not allow doctors to increase dose for at least 5 to 7 days.

 

  • Before increasing dose, patient should be observed at peak ( 4 to 5 hours after drug is given)

 

  • A PMP which is central registry system that a doctor can use to retrieve information on all medications that a patient is currently prescribed. (This needs to be made mandatory that doctors use before prescribing) Many states have these but it is not mandatory to use. These are also NOT connected state to state.

 

  • Require doctors NOT to start methadone until physical is complete. (The federal regulations allow 14 days to complete the physical) States can require physical to be complete BEFORE the first dose.

 

  • Never allow a patient to start on methadone if they have benzodiazepines in their system.

 

  • Mandatory reporting of all deaths when patient is receiving methadone.

 

  • People that divert methadone that causes death need to be prosecuted. There are already laws in place in most states but most are not being enforced.

 

This is a video on Naloxone, a lifesaving drug that can reverse opiate overdoses.

Blue For Prescriber Continuing Education Program     (This will not be a mandatory program. Can you believe that? )            

 

8 Responses to What is the Solution?

  1. debbie wilson had this to say about that:

    I was chit chatting with a police officer the OTHED day. Mostly about the Methadone Clinics.
    He told me that the police have been given strict instructions recently to stay away from Clinics and look the other way as to the drug deals going on there!
    Wow!
    Unbelievable!
    Florida Laws !

  2. debbie wilson had this to say about that:

    Can a person on methadone be Marshman acted in the state of Florida?
    A Volusia county judge ordered my daughter to go down on dose to 40mg so she could go into a detox.
    My daughter has made medical excuses as well as down right not obeying the judge.
    She did get down to 40 but now what?
    Nobody wants to detox her?
    St Marshman has given me the run a round. It all depends on the dr they say.
    She even volunteered to go to a hospital to detox and of course she was believable!
    She’s still going to Orlando methadone clinic with nobody to answer to!
    It’s been 3 months!
    Are the judges uneducated on methadone?
    And if it’s legal can it be a READON to Marshman act ??

    • tonya1968 had this to say about that:

      I really don’t know the answer to that but your probate judge should be able to answer that I would think. There are places that will detox for methadone but as with any addiction she has to want it. To answer your question about judges, not only are many judges uneducated so are the doctors. It’s really scary! I know how hard it is as parent to watch your child struggle and not be able to do anything about it but pray for her. If you want names of places that detox for methadone please let me know. I wish I could be of more help. You and your daughter are in our thoughts and prayers! (HUGS)

    • debbie wilson had this to say about that:

      Update on having my daughter Marshman Acted in Volusia Co Fl .
      After 3 hearing of judge ordering her to drop to 35 mg in order to be admitted to St Marshman Facility. She came to court stating Che wAs at 40 however no documentation. I personally told court she buys in parking lot as well. He told her she can just do her detox in a jail for a week.
      After a week, in jail with no supervision or medical history she came to court totally not knowing who she was and had been on sucide watch. She was in BAD shape and ordered her then to have nurse take her to the phych ward at SMA. She was there two weeks and her mental state went. Downhill quickly. We were not given info by doctor, staff, nurses. We wanted to know what happen in jail and crisis unit ?
      After all the secretly they finally took her go the detox ward ( some girl tried to choke her. So she goes to detox for 3 days and by our calls could tell something was terribe wrong. She could not recall her memory. Was hullucinating. And sat on bed 3 days naked thinking the devil was trying to poison her.
      She was evaluated and we were told they are transporting her to a very nice residential rehab.
      Strict rules of no visits from her 3 children or parents.
      After 1 night there we were called and her new counselor said no problem bring kids that evening.
      We freely walked out of rehab and came up to her children calling them zombies and that they were not her kids! Devastating!
      Quickly taken back to crisis center at SMA and she has been on 3 meds. She tried to jump backwards onto floor and go to heaven.
      Busted her skull and taken to Halufax for injuries and had staples. In head.
      It was then we begain to call demanding answers what happened from court to jail and now they say she is sketafrenic and they baker acted her saying she does not belong to me but to the state!
      They want to experiment another drug.
      I told them I wanted her out of that nasty place. And would pay for private facility or hospital. They said NO!
      I expect death at any time. They will not let her sign a med release or a power of attorney for her kids med help. I feel so GUILTY and don’t know what to do.!!

  3. tonya1968 had this to say about that:

    CHARLESTON, W.Va. — Under Gov. Earl Ray Tomblin’s wide-ranging substance abuse proposal, West Virginia would target so-called “pill mills” by following the successful lead of Ohio and Florida. But the
    bill also draws from a Kentucky anti-methamphetamine program that’s had decidedly different results, the Senate Health and Human Resources Committee heard Tuesday.

    The Senate committee took its first look at Tomblin’s legislation addressing various forms of drug abuse. It will resume its review Thursday, co-hosting a public hearing with its House counterpart in that body’s Chamber.

    Among the bill’s provisions, Tomblin has proposed licensing,inspecting and otherwise overseeing pain clinics. Law enforcement
    officials say some of these facilities recklessly hand out powerful pain drug prescriptions. The bill also would limit the amount of pills the clinics could dispense.

    David Potters, executive director of West Virginia’s Board of Pharmacy, told the committee that Florida and Ohio have shut down unlawful “pill mills” through such regulatory oversight. He singled out the experience of the Portsmouth, Ohio, area where he grew up.

    “They had eight or nine pain clinics. As soon as they put in this licensure provision, seven of them shut down,” Potters said. “They now have two, because those other seven realized, ‘We ain’t legitimate, we ain’t going to pass this test.'”

    Scrutiny of pain clinics has come amid an ongoing debate over medical treatment for pain and the arrival of such powerful narcotics as OxyContin. Potters said he did not believe the oversight provisions would threaten legitimate clinics.

    “We have to have end of life care pain management, as well as daily chronic pain management,” Potters told the ommittee. “The problem is whenever someone sees they can make money hand over fist.”

    “We have to have end of life care pain management, as well as daily chronic pain management,” Potters told the ommittee. “The problem is whenever someone sees they can make money hand over fist.”

    Tomblin also targets meth in his bill. It would add West Virginia to a multi-state database system that instantly tracks the sale of non-prescription cold remedies that contain pseudoephedrine and other potential meth ingredients.

    Dan Smoot, who heads an eastern Kentucky drug task force, told the committee that the real-time tracking system hasn’t worked in his state. Meth lab operators outmaneuver such tracking efforts by paying others to buy the ingredients for them, he said.

    Smoot advocates requiring a prescription for these cold medicines,something West Virginia’s Legislature considered last year. Although that proposal was strongly supported by law enforcement, the
    pharmaceutical industry mounted a major lobbying campaign against the bill. It died in the Senate on a tie vote, after passing the House 77-23.

    Potter said his board has endorsed such an approach. He also cited results in Oregon and Mississippi as evidence of success.

    “The number of meth labs — which is what you’re trying to affect by going prescription-only — still went through the floor, significantly reduced,” Potter said.

    Tomblin’s bill also includes regulations for methadone treatment,increased training for health care professionals, and a speeded-up
    tracking system for pain pill prescriptions.

  4. Cindy Haigler had this to say about that:

    My son was given methadone by a patient at kaiser. He was a pres. pain medicine addict. he worked in the pharmacy. I contronted the woman yesterday. She admitted giving the methadone to him. She had the gall to tell me it wasn’t her fault and I had no right to blame her. So angry, I will be seeking legal advice.

    • Bren ONeal had this to say about that:

      Cindy, I am deeply sorry about your great loss, your precious son.Thank you for sharing with us as painful as it is to tell.Your courage led you to the truth when you confronted this woman and I agree that you should seek legal counsel concerning her statement.What a smug heartless comment and attitude she had with you it makes me furious , also. She should be very afraid that she will be held accountable for your son’s death and prosecuted.If we can help in any way do not hesitate, please.Love, Bren

    • tracy pinnix had this to say about that:

      We also know the people that supplied our daughter with the methadone that cost her her life. They take no responsibility for supplying an illegally distributed substance that caused her death. Unfortunately no one has openly admitted guilt, only that our daughter was the only one at fault because she took it. We have been offering a reward for information , still no one will come forward as a witness:( I am sorry for your loss and pray that justice will be served.

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