|Posted:||February 2, 2015 03:21 PM|
|From:||Senator John H. Eichelberger, Jr.|
|To:||All Senate members|
|Subject:||Methadone Safety (Karl's law)|
|I plan to re-introduce legislation which addresses issues arising from the increased use and diversion of the prescription drug methadone. Currently, state guidelines in Pennsylvania with regard to methadone clinics are only found in regulation (28 Pa.Code 715.1, et. seq.), rather than in statute, as the General Assembly has yet to formally address this issue.
The bill was Senate Bill 509 in the last session, and was co-sponsored by: VULAKOVICH, STACK, GREENLEAF, KASUNIC, ERICKSON, WHITE, BREWSTER, ALLOWAY, RAFFERTY, WAUGH, WARD, TARTAGLIONE, FARNESE AND VOGEL.
The use of methadone as a treatment for both opioid drug addiction and pain management has expanded dramatically. Prescriptions for methadone increased nearly 700 percent over the last decade alone. It should come as no surprise that during this same timeframe of increased prescription and increased diversion, the number of poisoning deaths involving methadone increased 468 percent; and the rate of methadone deaths in younger individuals (age 15 to 24) increased 11-fold, according to the CDC National Center for Health Statistics. Corresponding to this increase in the use of methadone, the National Drug Intelligence Center in the U.S. Department of Justice reported a 109% increase (from 2003 through 2007) in the unlawful diversion of the drug.
Methadone is a drug with its own unique properties. According to the FDA, the short duration of analgesic effect with methadone combined with its significantly longer half-life, increase the risk for methadone toxicity. It is potent and long-acting. Unlike other drugs, therapeutic and lethal concentrations overlap with methadone, particularly when someone is just starting to use the drug, giving uneducated, inexperienced users ample time to make deadly mistakes. A dose of the drug can begin to work slowly in the body and last from 12 hours to several days or more. As noted by the Substance Abuse and Mental Health Services Administration (SAMHSA), one pill or one dose can kill a non or low opiate tolerant person. Even a day or two after the drug is taken, it has lead to deadly consequences for those who mix alcohol or other drugs. Deaths have been reported among children and adults who have accidentally taken methadone, and fatal intoxications have also occurred during the first weeks of treatment or adjustment of the methadone dose.
One tragic example of the serious dangers of diverted methadone occurred in October of 2006 when a young man, Karl Hottenstein, sought treatment for an addiction to painkillers prescribed after an auto accident. He was turned down by a hospital and a standard drug treatment provider, and thereafter died from a liquid dose of methadone diverted from a clinic.
An example of the highway dangers of methadone treatment tragically occurred in my district in 2004. In that year, shortly after an individual left a methadone clinic, she swerved into oncoming traffic causing a horrific accident. She was killed, and the driver of the other vehicle was left with severe and permanent brain damage. According to court records and a press release released by attorneys representing the driver's family, methadone combined with other prescribed antidepressants and sleeping pills, caused her erratic driving. At one previous visit, the clinic recorded in her chart that she was “falling asleep in line waiting for her methadone,” and during another visit “could not even sign her name." Whereas common medical procedures require a chaperone whenever any mild form of sedative is used, it is common practice for methadone patients to be allowed to take their dosage and leave without a driver.
The legislation would amend the “Pennsylvania Drug and Alcohol Abuse Control Act” to require methadone clinic protocols to increase both patient and highway safety. Specifically, it would include the following:
Introduced as SB532