November 13 & 14, 2008; Nashville, TN

OVERVIEW

Evidence suggests that the illicit use of methadone in the United States is a growing public health problem, resulting in a dramatically increasing number of deaths in recent years. As part of a response to this public concern, Drug Enforcement Administration and the Office of National Drug Control Policy (ONDCP), High Intensity Drug Trafficking Areas (HIDTA) hosted state and local law enforcement personnel at a conference held in Nashville, TN to consider abuse and diversion issues with methadone. The increase in methadone overdoses and deaths has pain, regulatory, health and law enforcement officials facing a quandary: how to stop methadone abuse without curtailing its valuable uses.

Methadone has become increasingly popular in recent years as a low-cost and effective pain-management tool. In addition, methadone is used effectively to treat opioid addiction. In most states with increased methadone deaths, the methadone being abused appears to be tablets prescribed for pain. It is clear that increased sales have made these opiate analgesics more available, and ARCOS data demonstrate increased prescribing of this drug. As a result, more of the opiate analgesic is available increasing the potential for abuse. The recently published Florida Medical Examiners' report directly associates methadone with an increase in fatalities, however, data on abuse and diversion methadone still remains a question.

Attached are the agenda and PowerPoint slides presented by the speakers at this meeting and some of the discussion points raised with participants. Expert speakers addressed a range of topics related to methadone awareness, providing attendees with an overview of the methadone mortality epidemic; side effects of methadone and the potential hazards with a worsening risk-benefit balance with over-treatment and/or abuse; legal perspectives; and the challenges and issues facing diversion of methadone. Individuals from 26 states participated in the conference. Participants at the conference described practices and strategies used by Opioid Treatment Programs, State Methadone Authorities (SMA), along with the federal, state and local law enforcement response to the issue of methadone overdoses, referring specifically to oversight efforts and investigative techniques.

The conference goal was to encourage awareness and initiate response to the methadone issues particular to their states. Participants were encouraged to communicate with, and inform public agencies, utilize prescription monitoring programs, and partner with Federal agencies to address the dramatic rise in methadone deaths. Many of the questions still remain unanswered with regard to these deaths. By raising awareness, Federal agencies such as the DEA and ONDCP/NMCI hope to yield better information on the sources of diversion of methadone implicated in overdose deaths.

AGENDA

o:103008;u:110508,121808