Study discovers danger in pain drug

OHSU researchers find methadone may cause cardiac arrest

By peter korn

The Portland Tribune, Jan 11, 2008, Updated Oct 30, 2009 (2 Reader comments)

Methadone, a drug once used mainly to help heroin withdrawal symptoms but now increasingly used for pain relief, can cause sudden cardiac death even at the levels prescribed by physicians, according to a study published Thursday by an Oregon Health & Science University researcher.

Until a decade ago, methadone was prescribed almost exclusively to help heroin addicts deal with the effects of withdrawal.

But in recent years, physicians have turned to the drug for chronic pain relief, because the generic synthetic opiate costs a fraction of other painkillers such as Vicodin and OxyContin.

The new study says patients taking methadone for any reason are at increased risk of cardiac arrest, regardless of the dose or whether they have any previous heart conditions.

In recent years reported deaths among people taking methadone have increased dramatically, but most reports focused on the dangers of overdosing.

One of the appeals of methadone for pain relief is that it is very long lasting. One dose can remain in the body for up to 36 hours, increasing the possibility of overdose among people who take a second dose while the drug remains in their system.

In fact, Oregon ranks among the states with the highest rates of death from methadone. The per capita rate of methadone deaths increased 1,250 percent between 1999 and 2004, according to data from the federal Centers for Disease Control and Prevention.

The new report says that even properly dosed, methadone can kill. And the rate of death may be much higher than public health officials previously suspected.

OHSU cardiologist Dr. Sumeet Chugh, lead researcher on the study, said he first suspected there might be a relationship between methadone and sudden cardiac death when the Oregon Health Division sent out an alert four years go that said death rates among methadone patients in Oregon had quadrupled.

Methadone, he said, has been known to affect cells of the heart, which can lead to cardiac arrest.

Chugh leads the Oregon Sudden Unexpected Death Study at OHSU, which has given him access to study all cases of sudden cardiac arrest that occur in the Portland metropolitan area.

Working with the state medical examiner, Chugh looked at 22 Portland-area cases of death in which people had therapeutic, but not lethal, levels of methadone in their blood.

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