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Methadone-Associated Overdose Deaths: Factors Contributing to Increased Deaths and Efforts to Prevent Them

GAO-09-341 Published: Mar 26, 2009. Publicly Released: Mar 31, 2009.
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Prescription drug abuse is a growing public health problem. In particular, methadone-associated overdose deaths--those in which methadone may have caused or contributed to the death--have risen sharply. Before the late 1990s, methadone was used mainly to treat opioid addiction but has since been increasingly prescribed to manage pain. Taken too often, in too high a dose, or with other drugs or alcohol, methadone can cause serious side effects and death. Methadone-associated overdose deaths can occur under several different scenarios, including improper dosing levels by practitioners, misuse by patients who may combine methadone with other drugs, or abuse--using the drug for nontherapeutic purposes. This report examines the regulation of methadone, factors that have contributed to the increase in methadone-associated overdose deaths, and steps taken to prevent methadone-associated overdose deaths. GAO reviewed documents, laws and regulations, data, and research from relevant state and federal agencies, including the Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA). GAO also interviewed federal officials, officials in five selected states, officials from professional associations and advocacy groups, and experts in pain management, addiction treatment, and forensic sciences.

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Substance abuseControlled substancesData collectionDocumentationSubstance abuseDrug abuse preventionSubstance abuse treatmentDrugsEducationFederal agenciesFederal lawFederal regulationsstate relationsLaw enforcementLicensesMedically necessary treatmentsMethadone maintenanceMonitoringNarcoticsPharmaceutical industryPhysiciansPrescription drugsProduct safetyPublic healthPublic health legislationRegulationRehabilitation programsReporting requirementsRequirements definitionSafety regulationSafety standardsStandardsState lawSubstance abusePolicies and procedures