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Drug Deaths Linked To Methadone Mixing

Tuesday, June 23rd, 2009 Drug Deaths Linked To Methadone Mixing

There are calls for tighter controls over the prescribing of drugs to methadone users after a new report found that 88% of recovering addicts from Scotland who died were taking a potentially dangerous combination of anti-anxiety drugs along with methadone.

The report, carried out by Dundee’s Ninewells Hospital and Medical School and the Royal College of Surgeons in Ireland, followed 2378 addicts in Tayside over an 11-year period. It found that 16% of addicts were over-using methadone and taking more than had been prescribed to them.

Eight percent of those studied until February 2004 died and drug dependence was cited as the principal cause of death in a third of such cases.

The authors of the study found that the co-prescribing of benzodiazepines, which includes Temazepam and Valium, was thought to be a ‘recipe for disaster’ as this was associated with drug-related death. There are now calls for improved monitoring of the prescription of such drugs.

The report also stated that 77% of those who had died had been admitted to a psychiatric unit in the past and nearly half were being co-prescribed anti-depressants.

The study highlighted the value of “stabilised prescribing” and called for more regular urine monitoring and a possible ban on the co-prescribing of anti-anxiety drugs.

The report states: “This community- based study shows that important elements in the process of care when providing methadone maintenance are likely to influence each patient’s risk of death. Prescribing of methadone could be improved, particularly as regards dosage, co-prescribing of benzodiazepines, and monitoring.”

The authors of the study say that the co-prescription of benzodiazepines and history of psychiatric admission were linked to drug related deaths.

According to the Scottish Government, five people die every day from drink and drug abuse. There are also an estimated 20,000 drug users that receive methadone in Scotland all of which costs the government £5bn every year.

Last year official statistics from the General Register Office for Scotland revealed that there were 455 drug-related deaths in 2007, a quarter of which involved methadone.

Such figures have led to claims that Scotland is losing its war on drugs.

Many health experts officially advise against the prescribing of methadone and benzodiazepines as it increases the effects of the drugs and there is an increased risk of overdose. The mixture can send patients into a sleep so deep that they stop breathing and die.
The use of benzodiazepines boomed in the 1960s as a supposedly safe alternative to barbiturates, but GPs subsequently reined back on prescribing them following evidence of significant side-effects including addiction.

Of the 37 different Scottish Drugs Forum treatment services across 13 local authority areas, eight said there was an increase in the street availability of the drugs, known as “blues” or “vallies”, and a further eight reported an increase in people mixing benzodiazepines with heroin, methadone and alcohol.

There has been widespread concern that the vast majority of addicts on the £6.5m-a-year heroin-replacement programme in Scotland are still taking illegal drugs years later.
In the latest study, researchers found more than 40% of patients were prescribed
methadone for more than three years and just over half were still on treatment at either the date of death or the end of the study more than 11 years later.

“Overuse of methadone may be a marker of less rigorous follow-up and communication between prescribing general practitioners and dispensing community pharmacists,” the analysts added.

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