Increases in Methadone-Related Adverse Events. Is it pills or liquid?

1. Increases in Methadone-Related Adverse Events. Is it pills or liquid? J. C. Maxwell, The University of Texas at Austin, Addiction Research Institute The number of adverse events related to use of methadone is increasing, and it is hypothesized that this increase is primarily due to methadone pain pills and not to liquid methadone used in narcotic treatment programs. Data from a number of sources are analyzed. Results: The number of deaths with a mention of methadone reported by the National Center for Health Statistics (NCHS) increased but the type of methadone involved was not reported.1 In Texas, the total number of deaths with a mention of methadone increased but drug overdose deaths of patients in Texas narcotic treatment programs did not. The proportion of admissions to treatment program of clients with a primary problem with illicit methadone has remained stable. The Automation of Reports and Consolidated Orders System (ARCOS) reported that between 2000 and 2006, the amount of pills ordered in the U.S. (grams/100,000) increased by 277%, the amount of diskettes increased 163%, and liquid increased 99%.The National Forensic Laboratory Information System (NFLIS) was able to identify the formulation of about half the methadone items examined across the U.S. The number of calls to Texas Poison Control Centers involving human exposure to methadone increased between 1998 and 2006. Of the 2006 calls, 729 involved pills, 192 were unreported formulations, 53 were diskettes, and 13 were liquid. Conclusion: ARCOS shows increased sales of the methadone pills, NFLIS shows increased numbers of pills identified, and the increase in calls to poison control centers due to pills is shown in the Texas data. Other data sources either do not report or underreport formulation so the role of pills in the increased number of deaths cannot conclusively be established, but overdose deaths among narcotic treatment clients comprised only a small proportion of the increasing number of methadone deaths in Texas. 1 Lois A. Fingerhut, Increases in Methadone-Related Deaths: 1999 2004 http://www.cdc.gov/nchs/products/pubs/pubd/hestats/methadone1999-04/methadone1999-04.htm • Presented at the College on Problems of Drug Dependence, 2007 • Contact Jane Maxwell, Center for Excellence in Epidemiology, Gulf Coast Addiction Technology Transfer Center. jcmaxwell@mail.utexas.edu or 512 232-0610. • Supported by the Center for Substance Abuse Treatment Grant UD1 TI13423