Raising awareness of methadone’s danger

Jonathan Lucas Levine should be celebrating his 21st birthday this month. Probably he would be in college by now, studying to be a math professor or perhaps a psychologist. Surely he would have plenty of friends. The way other kids used to follow him around, his mom dubbed him the Pied Piper.

Instead, Donna Levine sits in her Orlando, Fla., apartment surrounded by photos of her only child and tries not to cry again. Three years ago this month, at 18, Jonathan died of a drug overdose.

Among the mix of chemicals in his system was methadone — a drug that is readily available, relatively cheap and legal. The medical examiner ruled that methadone was the key ingredient that made the overdose lethal.

“People just don’t know about the dangers,” Donna Levine said. “Kids take these pills from their parents’ medicine cabinet, and they have no idea what they’re getting into.”

Levine is on a mission to educate parents and their children about those dangers. She calls her fledgling nonprofit organization Mad Over Methadone — or MOM for short — and has sold her car to cover start-up legal expenses.

“I have to do this,” the 52-year-old said. “This is my purpose.”

While most people know methadone as a treatment for addiction to heroin, in recent years the drug has become an increasingly popular — if controversial — choice to treat severe pain.

“I hear stories all the time of the drug being misused,” said Monte Drenner, an Orlando mental-health therapist and certified addiction professional who supports Levine’s efforts. “Most people are naive. They have the idea that if something is prescribed, it’s safe.”

But that’s a false impression.

According to a report last year from the National Center for Health Statistics, “the number of poisoning deaths involving methadone increased nearly sevenfold from almost 790 in 1999 to almost 5,420 in 2006, which is the most rapid increase among opioid analgesics and other narcotics involved in poisoning deaths.”

A 2009 report from the Government Accountability Office said the spike was partly due to the drug’s increased use in pain management. The report points to data from the Drug Enforcement Agency showing that methadone distribution to pharmacies and practitioners nearly tripled from 2002 to 2007.

Dr. Lynn Webster, a Salt Lake City-based anesthesiologist who cofounded the nonprofit LifeSource to address issues such as unintentional overdose, blamed the industry-wide push for cheaper pain-management drugs as an alternative to expensive options like OxyContin.

“Methadone represents just 5% of treatment of chronic pain but is associated with about a third of all the deaths,” Webster said. That’s partly because many physicians don’t know how to safely start patients on the drug, or how to carefully raise the dose. And even in cases where the doctor does everything right, “patients try to manage their own pain in spite of doctors’ orders,” he added.

The Food and Drug Administration issued a public-health advisory in late 2006, warning that “methadone use for pain control may result in death and life-threatening changes in breathing and heartbeat.” The FDA further noted that prescribing methadone for pain is a “complex” issue because of potentially fatal interactions with other drugs and because methadone has a long half-life, staying in the body for at least several days.

Dr. Stacy Seikel, medical director at the Center for Drug-Free Living in Central Florida, said the drug has a legitimate — and successful — use in treating addiction to heroin and OxyContin. But Seikel said she never prescribes it to anyone taking benzodiazepines, a class of drugs used for anxiety, insomnia, seizures and muscle spasms.

“It’s very powerful, particularly in people who haven’t built up any tolerance,” she said. “And when you combine it with something like Xanax or Ativan, you basically just stop breathing.”

The primary source of the problem, Seikel said, is methadone that is prescribed by “pill mill” doctor offices frequented by drug-seeking patients. Those prescriptions too often end up being sold by the patient for a profit.

That’s what happened in Jonathan’s case.

On Sept. 20, 2007, while visiting a friend in Altamonte Springs, he complained of excruciating pain in his face and sinuses — the result of a surgery that had left him with an implanted metal plate and a pair of titanium screws.

The friend’s mother, Donna Levine said, sold Jonathan a pair of methadone pills. He took only one, but he already had taken a trio of other drugs prescribed by his doctors for pain and mood stabilization.

Later, he would call his mom to say he was too tired to come home and was spending the night with a friend. By morning, he was dead.

“The last thing I told him is that I loved him,” Levine said.

It took two years of grieving before she knew what she wanted to do. With help from some young people who knew her son, she plans to take the message to schools, youth groups and camps. She is also trying to spread the word to parents — and offer solace to mothers and fathers who learn of the danger too late.

“I am not one of these people who say it will all be worth it if it saves one life,” she said. “I want to save a lot of lives.”

Amina Khan of the Los Angeles Times contributed to this report.

ksantich@orlandosentinel.com