Methadone Use Compared With Morphine SR
the Clinical Pain Advisor take:
Methadone use carried a 46% increased rate of mortality when compared with morphine sustained release, according to a risk ratio calculation published online in JAMA Internal Medicine.
Researchers from Vanderbilt University Medical Center calculated the risk ratio related to methadone using Tennessee Medicaid records for 1997 through 2009 – accounting for 6,014 people who took methadone and 32,742 prescribed morphine,
The team accounted for some 196 covariates, including recent medical care utilization, demographic factors, dosage and other variables. Methadone’s excess risk was present in the lower half of the dosing range.
According to the study, there were some 4.4 million methadone prescriptions written in the United States in 2009. The researchers noted that by their calculations, methadone’s higher risk ratio translates to 72 excess deaths per every 10,000 person-years of treatment — again, compared to morphine SR.
The sole previous study comparing these two drugs produced a nearly opposite result: 44% percent decreased mortality with methadone, but that study included many sick patients, according to a press release on the study.
The study was supported by the National Institutes of Health (grants HL081707, AR064768).
There were some 4.4 million methadone prescriptions written in the United States in 2009.
Although methadone is often prescribed for use outside of a hospital setting, new research shows that this unsupervised usage puts patients at a 46% higher rate of death than with other forms of painkillers.
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