Eight years ago, officials from the state of Washington adopted a cost-cutting measure related to prescription painkillers.
People with subsidized health care are being given methadone rather than other types of pain medication.
Methadone is different from other painkillers in two major ways. First, it’s cheaper. Second, it’s less predictable and more deadly. As a result, there has been a rise in deaths due to accidental methadone overdoses. According to an investigation conducted by the Seattle Times, the deaths are clustered among some of the state’s poorest citizens.
Methadone is a synthetic narcotic drug that belongs to a powerful class of painkillers known as opioids. Fentanyl, OxyContin and morphine in this class of drugs. With OxyContin and other opioids, the drug dissipates from the body within a few hours. In contrast, methadone can build up within the body, creating a toxic reserve that impairs the respiratory system. Without warning, patients can succumb to what doctors call “silent death” – they fall asleep and never wake up.
Within the opioid class, methadone accounts for less than 10 percent of painkillers prescribed in Washington, but according to the Seattle Times it accounts for more than half of the overdose fatalities. The poorest patients, including Medicaid recipients, workers on disability as well as state employees, account for 48% of methadone deaths in the state.
Washington’s methadone death rate is among the highest in the country.
California, which has more than five times as many people as Washington, as fewer methadone deaths. The Times article described a case that dramatically illustrates the problem. Two sisters were injured in a car accident in 2009 and needed pain medication. The sister with private insurance was prescribed OxyContin. The other sister, who was on Medicaid, was given methadone. She suffered a fatal overdose within a week.
The situation in Washington is an example of the politics that are becoming associated with painkillers. In the current tight economy, budget cuts are having a critical impact on health care. Those who are most deeply affected are often the people who don’t have private insurance and rely on government health benefits. Washington is not the only state that is trying to save money by steering patients towards less expensive drugs. Across the nation, 31 states have a preferred drug list that includes methadone for pain. However, most other states include other painkillers on the list, giving doctors additional options for pain management. Hopefully legislators in Washington will pay attention to the deadly statistics and modify the current methadone policy.