I'm writing to you about the methadone epidemic taking place in the United States .
I am writing on behalf of HARMD (Helping America Reduce Methadone Deaths). We are the families of victims and those yet to be victims of methadone. More ... I have come together with many other families throughout the United States who have lost loved ones to methadone.

On June 24th 2006 I lost my fiancé (Ron) to methadone prescribed by a physician with a combination of other medications that acted as additives to the Methadone. He was a professional Jai Alai player at Hamilton Downs Jai Alai in Jasper, FL and had knee surgery after an injury on the court. He became addicted to the percocet he was prescribed. He checked hi mself into Greenleaf in Valdosta , GA (part of South Georgia Medical Center ) for detoxification. Upon entering the facility he was drug tested and did not come up positive for opiates or any other drugs (he had stopped taking the percocet 4 days before entering the facility). He was prescribed by a Dr. excessive amounts of methadone (for a person without a known tolerence) with valium and Klonopin. On the fourth day in detox he died sometime between 2am and 1pm in the afternoon (he was never checked on in all of those hours). When hi s body was found at 1pm he was already in rigor mortis. He was extremely neglected bordering abusive considering he was supposed to be monitored every 1/2 hour according to hi s medical charts. The night before he died he was complaining of migraines and vomiting, apparently the staff thought he was still experiencing withdrawals (but again he had NO drugs in hi s system upon entering the facility) and was not concerned about these symptoms. The symptoms of methadone toxicity mimic withdrawal symptoms; physicians and staff must be very cognizant of the complex properties and metabolization of methadone. There were many errors made in my fiancé's death including the fact that he was given numerous amounts of additive medications such as benzodiazepines (valium and klonapin). He had only been taking percocet for about 4 months and according to the DSM IV he wouldn't be an appropriate candidate methadone maintenance treatment.

We are asking government agencies to enact stricter guidelines in prescribing methadone for any reason. It must be mandatory that all doctors be certified and trained in the pharmacology of methadone; inpatient stays must be required during induction to methadone; all staff be extensively trained in monitoring methadone patients for symptoms of toxicity. Clinic patients should be tested for legal and illegal drugs that are taken with methadone to get "high" or experience "euphoria" such as benzodiazepines, alcohol, cocaine, heroin, marijuana etc... and face severe consequences / mandatory detoxification from methadone program. When presenting inebriated at clinic, clinic should also document such activity as well as prevent client from driving. Take home doses for all patients receiving methadone should be eliminated thus preventing the risk of diversion or precautions such as pill safe should be implemented. More ...

Current statistics show that nearly 4000 people a year die from methadone. These deaths are mostly happening to pain management and detoxification patients within the first 10 days of taking initial dose. Most of these deaths are related to methadone prescribed with other medications that react as additives with the methadone. Diversion of methadone is a serious problem because it lands this most deadly drug on streets. Statistics also state that methadone is contributing to more deaths nationwide then heroine and only second to cocaine deaths.

The government did take notice after the 2003 record number of deaths associated with methadone and the Bush administration responded by gathering the top experts on drug overdoses, doctors, researchers, and medical examiners, as well as representatives from the federal Drug Enforcement Administration, Food and Drug Administration, and Substance Abuse and Mental Health Association. Finn and Tuckwiller (2006) report that "the man hired to research and write the report based on the conference, as well as background paper for conference participants, was Stewart B. Leavitt, and addiction specialist whose work is funded by the makers of methadone". Stewart B. Leavitt PhD served as researcher/writer for A National Assessment of Methadone-Associated Mortality: Background Briefing Report from the U.S. Department of Health and Human Services. Stewart B Leavitt also writes Addiction Treatment Forum Methadone Dosing & Safety in the Treatment of Opioid Addiction which is funded by Mallinckrodt, Inc. a manufacturer of methadone. My question is why hasn't a team of independent researchers not funded by pharmaceutical companies; a person or group of people that stand to gain no financial benefit on the outcome of the studies been hired to conduct the research? Finn and Tuckwiller (2006) report that "the man hired to research and write the report based on the conference, as well as background paper for conference participants, was Stewart B. Leavitt, and addiction specialist whose work is funded by the makers of methadone". Stewart B. Leavitt PhD served as researcher/writer for A National Assessment of Methadone-Associated Mortality: Background Briefing Report from the U.S. Department of Health and Human Services. Stewart B Leavitt also writes Addiction Treatment Forum Methadone Dosing & Safety in the Treatment of Opioid Addiction which is funded by Mallinckrodt, Inc. a manufacturer of methadone. On the forum associated with his website several of the clinic participants speak of diverting, misusing, stockpiling, selling, and potentiating methadone and other prescription drugs.

This methadone epidemic and deaths associated with it are not going away. It's only getting worse; I get contacted by families on a daily basis who have lost someone to this drug. At what point do we value human life over the convenience of others? Methadone patients, whether they are pain or clinic pose a risk to themselves and society as a whole if they are not monitored, dosed, and assessed correctly. Clinic patients getting into cars after being dosed who are using benzodiazepines, alcohol, marijuana or other opiates are killing innocent people on the road. This type of harm reduction is not saving lives it's taking them. The government cannot continue to be a legal drug dealer in order for its citizens to "behave".

I know the rules are in place for the clinics but they are NOT being followed. Patients sell take homes outside the clinics. In one news article a man died in the parking lot of a clinic after taking his brothers take home. This drug is too dangerous to be allowed in medicine cabinets! There is A LOT of money to be made from methadone but what expense is that money being made at? When do the risks outweigh the benefits of this drug? How many more people must die before changes are made that actually save lives?
I have called several methadone clinics and have found out that many do not test for marijuana and are not open 7 days a week. These two things are of special concern to my organization because all methadone patients will receive a take home bottle of methadone on Saturday for Sunday (the day they are closed) whether they are new to the program or have been abusing other drugs. Marijuana and methadone have an effect on the user very similar to heroin. Many clinics do not test for marijuana because it is not believed to be a drug of choice or a "hard drug", I beg to differ because of the effect when combining the two have the potential to be more dangerous then the user/staff is aware. This poses a serious public health risk to those on the road innocently driving to work or school.
The state of Delaware has just added Methadone to the list of medications covered under the Medicaid program that require prior authorization for pain treatment. The potential of abuse, diversion, and overdose to new patients being prescribed methadone is overwhelming. The unique properties of methadone, it's long half life, short analgesic properties, cardiac risks and it's negative interaction with numerous drugs make it an optimal choice as a last result treatment for chronic pain.

Thank you for taking the time to read this letter.

Sincerely

Melissa Zuppardi