Great post, Liz. Methadone can be very effective - it is what I take - but it absolutely must be prescribed correctly. All the evidence suggests that it is very safe in the hands of experienced docs. Of course many of the deaths come from the population of addicts, but I think it is clear that, unfortunately, deaths in the chronic pain population are increasing.

Personally, I would never trust a physician prescribing methadone for me unless I was absolutely sure about their background, and that they had lots of experience specifically with the medication, and had talked with them about their philosophy and prescription practices. I realize that this may not always be possible for all of us - so we have to be as informed as we possibly can.

And there is another potentially serious problem - cardiac arrhythmias. This issue has been know for some years now but is still ignored by some docs. Anyone who is starting methadone needs to screened for cardiac risk factors, which includes an EKG.

Here are a couple of references:

Methadone heart health
Abnormal heart rhythm


rfinney