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Chronic Pain in Florida: Déjà Vu All Over Again?
May 25, 2005
Maia Szalavitz
Methadone scare story short on facts, balance.

You might think that the recently-filed $600 million lawsuit against the Orlando Sentinel, and the embarrassing series of corrections and retractions that followed its coverage of painkillers and pain treatment, would make the Florida press especially careful in the coverage of this issue.

But you would be wrong. On May 15, the St. Petersburg Times ran an article about methadone (“‘Safe’ drug a leading killer”) that could have been pulled from the Sentinel’s sensational, misleading and biased Oxycontin series of 2003.

The SP Times claimed that methadone — which many doctors have switched to after Oxycontin became stigmatized and likely to attract law enforcement attention — has now become a major threat to public safety.

But, crucially, it echos one of the Sentinel’s key mistakes: While the second graf notes that there have been 264 “methadone” overdose deaths in the state, it’s not until the 36th paragraph that readers are informed that “methadone” overdoses “often” involve several drugs. The paper fails to cite the actual statistic: Some 80% of opioid overdose deaths are due to addicts taking a cocktail of illegal drugs.

The paper cites a doctor who claims to “check MRI’s and other tests” to make sure that his patients’ pain “is real.” But there are no objective tests for pain—this is one of the reasons why doctors cannot ever be 100 percent sure that they haven’t either left a patient in real agony or given drugs to an addict. In fact, emotional pain and physical pain light up the same brain regions.

The St. Petersburg Times article also touts a database of prescriptions as “one of the best ways” according to Florida’s ‘drug czar’ to fix the problem, noting that the passage of legislation authorizing such a database was “stalled” by the privacy concerns of “some lawmakers.”

This is misleading: There was widespread public concern about privacy, so much so that the legislation, which was a priority of the governor, was not even put up for a vote. Both Democrats and Republicans opposed it. The St. Petersburg Times itself editorialized that the database could pose not only privacy problems, but could lead to greater under-treatment of pain.

Further, the article fails to mention that there is an antidote to opioids which is non-toxic and has been provided to addicts to reverse overdose in other states—but which is only used by medical professionals in Florida.

In Baltimore, for example, the drug naloxone (Narcan) has been given out at needle exchange programs for addicts—and overdose deaths are down 12% in the last year. The city’s health commissioner says that at least 52 lives are known to have been saved by the program. Pilot studies have been done both in the U.S and U.K.

Since most of the deaths in the article occurred amongst drug abusers, it is curious not to even mention this approach. Why not suggest that the antidote be provided to pain patients, just in case children or others in the household take medications that they haven’t been prescribed?

Finally, the article did not quote any pain patient advocates about the difficulty they have getting appropriate treatment in the face of constant media coverage calling any drug from which they find relief a “killer.”

When will the media recognize that there are two sides to this story?