1

 www http://www.cdc.gov/vitalsigns

Six times as many people 

died of methadone 

overdoses in 2009 than a 

decade before.

About 5,000 people die 

every year of overdoses 

related to methadone.

5,000

Methadone contributed to 

nearly 1 in 3 prescription 

painkiller deaths in 2009.

6x

1 in 3

Prescription 

Painkiller Overdoses

Use and abuse of

methadone as a painkiller 

Prescription painkiller overdoses* were 

responsible for more than 15,500 deaths in 2009. 

While all prescription painkillers have contributed 

to an increase in overdose deaths over the last 

decade, methadone has played a central role in 

the epidemic. More than 30% of prescription 

painkiller deaths involve methadone, even

though only 2% of painkiller prescriptions are

for this drug. Six times as many people died of 

methadone overdoses in 2009 than a

decade before.

Methadone has been used safely and effectively 

to treat drug addiction for decades. It has been 

prescribed increasingly as a painkiller because 

it is a generic drug that can provide long-lasting 

pain relief. But as methadone’s use for pain has 

increased, so has nonmedical use of the drug and 

the number of overdoses. 

* “Prescription painkiller overdoses” refers to deaths from using 

harmful amounts of opioid or narcotic pain relievers, including drugs 

such as Vicodin (hydrocodone), OxyContin (oxycodone), Opana 

(oxymorphone), and methadone.

See page 4

Want to learn more? Visit

July 2012

National Center for Injury Prevention and Control 

Division of Unintentional Injury Prevention
Problem

2

Methadone use 

poses risks 

Methadone is frequently prescribed 

for pain.

◊ Methadone, like other painkillers, is 

commonly prescribed for chronic problems 

like back pain even though it might not help 

these problems in the long run. 

◊ More than 4 million methadone 

prescriptions were written for pain in 2009, 

despite US Food and Drug Administration 

warnings about the risks associated with 

methadone.

◊ Methadone is available as a low-cost 

generic drug. It is often listed as a preferred 

drug by insurance companies.

Methadone’s risks include: 

◊ The difference between appropriate

prescribed doses and dangerous doses of 

methadone is small. 

◊ Methadone has special risks as a painkiller. For 

example, taking it more than 3 times a day can 

cause the drug to build up in a person’s body, 

leading to dangerously slowed breathing.

◊ Methadone can seriously disrupt the

heart’s rhythm.

◊ Methadone can be particularly risky when 

used with tranquilizers or other prescription 

painkillers.

◊ In one study, four in ten overdose deaths 

involving single prescription painkillers 

involved methadone, twice as many as any 

other prescription painkiller.

As methadone prescriptions have 

increased, so have the number of 

methadone overdoses. But many 

people who die of painkiller overdoses 

don’t have a prescription. How can 

this be? 

It’s because some of these 

prescriptions are illegally sold or 

given to people who use them for 

nonmedical reasons. This is known as 

diversion.

Diversion is a major factor in the 

prescription drug abuse epidemic. 

More careful prescribing will help 

reduce diversion and save lives.

Why have methadone overdoses increased?

Rx

Diversion
3

Methadone’s share of prescription painkillers dispensed in each state

Death rate from overdoses caused by a single prescription painkiller 

Source: Substance Abuse and Mental Health Services Administration, Center for Behavioral Statistics and Quality, Drug Abuse Warning 

Network Medical Examiner Component, 2009.

Buprenorphine Hydromorphone Hydrocodone Oxycodone Fentanyl Morphine Methadone

12

10

8

6

Rate per 100 kilograms

4

2

0

Growth of methadone use for pain and methadone overdoses 

Sources: National Vital Statistics System, 1999-2009; Drug Enforcement Administration Automation of Reports 

and Consolidated Orders System (ARCOS), 1999-2010.

Methadone use for pain (kg/100,000 people)

Methadone-related overdose deaths per 100,000 people

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

3.0

2.5

2.0

1.5

Rate per 100,000 people 1.0

0.5

0

Percentage

4.4 - 6.6

6.7 - 8.5

8.6 - 11.4

11.5 - 18.5

CA

FL

NY

WA

MT

OR

NV

UT

ID

WY

KS

LA

AL

NC

ME

WI

AR

IN

MI

AK

HI

AZ NM

CO

ND

SD

MN

IA NE

TX

MS

SC OK

MO

TN

KY

IL OH

WV MD

DE

NJ

VT

RI

CT

NH

MA

PA

VA DC

GA

Source: Drug Enforcement Administration 

Automation of Reports and Consolidated 

Orders System (ARCOS), 2010

Numbers account for differences in drug strength.
4

 www http://www.cdc.gov/vitalsigns

 www http://www.cdc.gov/mmwr

What Can Be Done

CS232209-B

The US government is

◊ Enforcing federal laws to prevent nonmedical 

use of methadone. 

◊ Educating health care providers and 

consumers about the correct use 

of methadone.

◊ Tracking prescription drug overdose trends 

and the impact of efforts to stop overdoses.

States can

◊ Develop and promote the use of safe 

prescribing guidelines for methadone.

◊ Support the use of methadone as a treatment 

for opioid dependence in opioid 

treatment programs.

◊ Use prescription drug monitoring programs 

to identify patients who are using methadone 

or other prescription painkillers for 

nonmedical purposes. 

Health care providers can

◊ Follow guidelines for prescribing methadone 

and other prescription painkillers 

correctly, including

•	 Screening and monitoring for substance 

abuse and mental health problems.

•	 Prescribing only the quantity needed based 

on the expected length of pain.

•	 Using prescription drug monitoring 

programs to identify patients who are 

misusing or abusing methadone or other 

prescription painkillers.

•	 Monitor patients on high doses for heart 

rhythm problems.

•	 Educating patients on how to safely use, 

store, and dispose of methadone and how to 

prevent and recognize overdoses. 

Health insurers can

◊ Evaluate methadone’s place on preferred 

drug lists.

◊ Consider strategies to ensure that pain 

treatment with any dose higher than 30 

mg of methadone a day (the recommended 

maximum daily starting dose) is appropriate.

Individuals can

◊ Use methadone only as directed by a health 

care provider.

◊ Make sure they are the only ones to use their 

methadone and never sell or share it 

with others.

◊ Store methadone in a secure place and 

dispose of it properly. See www.cdc.gov/

HomeandRecreationalSafety/Poisoning/

preventiontips.htm for correct storage and 

disposal of medications. 

◊ Get help for substance abuse problems 

1-800-662-HELP or 

www.samhsa.gov/treatment/.

For more information, please contact 

Telephone: 1-800-CDC-INFO (232-4636)

TTY: 1-888-232-6348

E-mail: cdcinfo@cdc.gov

Web: www.cdc.gov

Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333

Publication date: 07/03/2012