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Panel Issues Guidelines for Physicians Prescribing Methadone
February 19, 2009

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News Summary

A panel of independent physicians has developed cardiac-safety recommendations for prescribing methadone, an anti-addiction opiate that also has become increasingly popular as a painkiller, Reuters reported Jan. 23.

Methadone can trigger an irregular heart rhythm that can lead to cardiac arrest, and the panel recommended that opioid treatment programs assess clients for their risk of developing heartbeat irregularities, and combine this assessment with routine medical care "without reducing access to vital addiction treatment services."

The panel reviewed previous research, guidelines on addiction from the U.S. and other countries, information from regulatory agencies, and studies on physician awareness of adverse cardiac effects.

The recommendations included informing patients of the risk of heart-rhythm disturbances, asking about a history of heart problems, performing an ECG with frequent monitoring, if necessary, and considering other treatments if the results of the ECG indicated a high level of risk.

The recommendations appeared in the March 17, 2009 edition of the Annals of Internal Medicine.

COMMENTS ON THIS ARTICLE:

Posted by robert newman on 20 Feb 09 08:25 AM EST
suggest you give equally prominent coverage to an editorial that will be appearing in the same issue of the Annals: http://www.annals.org/cgi/content/full/0000605-200903170-00111v1 I believe it would also be interesting for readers to know how you define "independent" - independent of what, or of whom?

Posted by Penny Hall on 20 Feb 09 09:01 AM EST
And they recommended what to the "pain" clinics and the doctors they employ? I suggest that they look to themselves as the creators of this HUGE new issues. Perhaps one should look at the Methadone Mortality Assessment that was done. It clearly concludes because of research that the methadone deaths of recent years are attributed to the pain management field and not the opioid treatment field. It would appear to me that they are doing this publication to redirect the attention of the media from the proven cause of the deaths.

Posted by Denise on 23 Feb 09 03:24 PM EST
The way that this article is written is somewhat concerning. A barebones statement like "methadone can trigger an irregular heart rythym that can lead to cardiac arrest" without any statistics showing the infrequency of this occurrence and the fact that it typically is seen when there are other genetic factors or other medications involved is troublesome. I was always under the impression that this publication served the substance abuse community as a whole now I am not so sure. This is misleading and one sided. I plan on taking myself off of the e-mail list I am not sure how this type of ill constructed article advances effective alcohol and drug policy.

Posted by Marcos B. on 23 Feb 09 04:50 PM EST
I am apalled that a so called "respectable" publication can print an article with so little facts. Panel of "independent" physicians? What does this mean? These physicians don't agree with the majority? I have personal experience working with clients who have stated that methadone stabalizes their health, not worsen their health.

Posted by Tom Gardon, Join Together on 24 Feb 09 10:47 AM EST
The summaries that appear on Join Together are just that -- summaries of news and research articles that appear elsewhere online. They are provided as a service to our subscribers with the expectation that if the subject matter of a summary provokes a reader’s interest, the reader would be enticed to further investigate the subject being summarized. To that end, links are always provided to the original story and, when applicable, the original research or source material upon which the story is based.

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