GRAND RAPIDS, Mich. (WZZM) - A drug introduced 75 years ago to wean addicts off heroin is now the leading cause of prescription overdose deaths in Kent County.
The drug is methadone. It is widely prescribed as an inexpensive pain killer, but has become a killer in its own right, eclipsing heroin as the single greatest cause of fatal overdoses.
And it's not just here. Methadone accounts for nearly one-third of all fatal overdoses nationwide – a six-fold increase over the last 10 years.
"It's becoming a much greater cause of death the last few years,'' said Kent County Medical Examiner Dr. Stephen Cohle. "I think it's ubiquitous. I think it's all over.''
Methadone entered the public consciousness in the 1950s when American doctors began using it to treat heroin addiction. Today, about 500,000 people are participating in methadone treatment programs nationwide, including several hundred locally.
It's also effective for treating chronic conditions, such as back pain. Oxycontin had been the drug of choice, but that started to change in the late 1990s when addicts discovered it could be snorted or injected to produce an intense high.
Doctors began looking for an alternative drug with the same long-lasting effects of Oxycontin. Methadone fit the bill. It was also about 12 times less expensive than brand-name Oxycontin.
That's still the case. A 30-day regimen of methadone – 180 tablets - costs an average of about 13 cents per 10 mg pill. For Oxycontin, a 30-day supply of 60 tablets costs $8.12 per 40 mg pill.
"It started showing up in the pharmacy 10, maybe 15 years ago,'' said Mike Koelzer, owner of Kay Pharmacy on Plainfield Avenue NE. "At the time I was a little confused because I thought it was just for the methadone clinics helping people get off heroin.''
Methadone, like other Schedule II drugs, is heavily regulated because of the potential for abuse and addiction, Koelzer said.
"Now it's used for pain pretty much,'' he said. "The question is, a deeper question of was this the right drug for the right patient?''
That 's the same question being asked at drug abuse clinics, including Family Outreach Center on South Division Avenue in Grand Rapids.
Sara L. Paxton, clinical supervisor at Family Outreach Center, said it is sometimes tough to determine if people actually need methadone to treat chronic pain or to feed an addiction to opioids, including heroin.
"I've interviewed people who've said my drug of choice would be heroin, but if my access is limited or if it's cheaper to get something like methadone, then that's what they're going to get,'' she said. "And it might be easier to get if you don't have street connections for heroin, which isn't prescribed for anyone.'''
Prescriptions are sometimes filled for people feigning chronic pain. "They can be good actors,'' Paxton said.
A 30-day prescription of methadone typically costs about $30 for 180 pills. They're then sold on the street for between $1 and $5 each.
The Kent County Prosecutor's Office last month charged a Kentwood man with selling prescription methadone causing in death.
James Earl Gardner, 67, faces up to life in prison if convicted under the 2006 statute making it a felony to deliver a controlled substance causing death. "It's not a charge we file very often,'' Kent County Assistant Prosecutor James Benison said. "The circumstances in this case warrant prosecution.''
Gardner is accused of selling 28 methadone tablets to Michael Moesta, a Holland man with a history of drug abuse. Moesta, 22, was found dead in Nov. 2012 at a friend's house on Grand Rapids' Northeast Side. He died sitting on a couch with 18 methadone pills and $1,083 in his pocket.
"That's where you see the rise in abuse - younger adults and older teenagers,'' Paxton said. "They have grandparents, parents who may be prescribed pain medications. Going into the cupboard is much easier than connecting with a dealer on the street. That's how it starts.''
Cohle, the Kent County medical examiner, agrees. "Unfortunately, many individuals, particularly young individuals with a tendency toward drug use have migrated to methadone and we're getting a lot of overdoses on that,'' Cohle said.
Doctors often prescribe other pain killers, but turn to methadone if nothing else seems to work, Paxton said.
"A physician isn't going to have you come in for a minor procedure and say we're going to start you on methadone,'' Paxton said. "They're going to try something else prior to that. When it's taken not as prescribed or it's not your prescription, you don't know necessarily how your body is going to react.''
Taking methadone more than three times a day often leads to respiratory problems. Yet insurance companies still list it as a preferred drug because of the cost.
"A person with an overdose of methadone can – or will – stop breathing,'' Cohle said. "That's really what kills them.''