Frequently asked questions
What are opioids, and what is their place in medical practice?
What should I know about deaths from prescription drugs?
The second leading cause of accidental death in this country after car accidents is now drug overdoses. Many of these deaths involved opioids or other types of prescription drugs. Opioid poisoning now causes more deaths than either heroin or cocaine.
What factors are contributing to the increase in overdose deaths involving opioids?
- Impaired Control over drug use
- Compulsive use
- Continued use despite physical, mental or social harm
- Craving
How can I protect myself and my family from overdose involving prescription drugs?
- Put medicines in a locked cabinet and store the key.
- Do not store prescription drugs in a bathroom medicine cabinet (these rarely lock), the kitchen cabinet or a car glove compartment.
- Do not store medicine bottles in nightstands, purses, coat pockets or other locations easily accessed by others.
- Do not store medicines in the refrigerator unless so directed by your pharmacist.
- Never take medicine in the dark. Always turn your lights on and wear reading glasses if needed.
- Read the label each time to check the dosage.
- Examine the medicine before taking it, checking for capsules or tablets that differ from others in the bottle.
- Follow directions carefully, including special instructions such as “Do not take with grapefruit” or “Take two hours before or after meals.”
- Dispose of unidentified and out-of-date medications as instructed by your pharmacist.
- Always tell your physician about all medications you are taking from any source.
- Use containers that separate each day’s dose so that an individual will not accidentally take a second dose because he or she forgot originally taking it.
- Avoid taking medicines in front of children, because children like to imitate grown-ups.
- Use child-resistant packaging when possible and replace caps securely after each use.
- Never call medicine “candy” Call it “medicine.”
- Do not discard medicines in the wastebasket where children can find them.
- When giving medicine to a family member, check the label each time you give it.
- Keep track of doses.
- Never share medications with others.
- If you suspect someone has stolen your prescription, report it to your local police department. You may save a life.
What does the FDA say about methadone?
On November 26, 2007, the FDA issued an advisory warning of potential fatal outcomes associated with methadone. The agency warned that "prescribing methadone is complex" because its analgesia wears off long before it is cleared from the body. The announcement coincided with new prescribing guidelines, which lowered the maximum suggested initiation dosage from 80 mg to 30 mg per day.
Is methadone a special risk for overdose? How is it different from other opioids?
Methadone deaths jumped 390% between 1999 and 2004. Methadone was responsible for 13% of drug-related deaths in 2004, even though it is not prescribed nearly as often as other types of drugs. One reason may be the unique way the drug accumulates in the body. Methadone provides pain relief for only 4-8 hours, but its effect on suppressing breathing may last for 2-3 days when a patient takes it for the first time. Patients need plenty of time to develop a tolerance to the breathing depressant effect of methadone. Any controlled substance can be hazardous when used outside of medical direction, but it is particularly important never to take more methadone than prescribed.
There also appears to be a small group of patients who converted from one opioid to methadone at a level that could be dangerous. This can occur when physicians use a conversion table that suggests an equal dose of two opioids. When this happens, the starting dose of methadone could be high enough to stop respiration.
