Timeline: State defends methadone as death toll rises
Each year, a committee of doctors, pharmacists and other medical experts evaluates drugs for safety and effectiveness. From its recommendations, the state is allowed to pick the least expensive drugs to prescribe to Medicaid patients, injured workers and state employees.
The Pharmacy and Therapeutics Committee is an independent panel, but its members are hand-picked by three state programs with a financial stake in the panel's decisions: Medicaid, Labor & Industries and the Health Care Authority, which oversees medical benefits for state employees. Representatives from these three entities attend committee meetings and often dominate discussions.
2003: 166 deaths linked to methadone
P&T committee holds its first meeting. Within a year, Washington selects methadone and morphine as its narcotic painkillers of choice.
2004: 256 deaths linked to methadone
Dr. Stuart Rosenblum, a pain specialist from Oregon, warns the committee against methadone, citing an increase in deaths linked to the drug. "Virtually no response," he says of the committee's reaction.
2005: 280 deaths linked to methadone
After hearing testimony that methadone deaths were alarmingly high in Oregon, committee member Dr. Carol Cordy asks state officials at the meeting, "Does Washington have numbers like Oregon?"
Dr. Jeff Thompson, chief medical officer of the Washington Medicaid program, provides a vague answer with no numbers. What Cordy didn't learn was that Oregon's methadone-associated deaths had begun leveling off by that time, while Washington's were shooting up, from 140 deaths in 2002 to 256 in 2004 (Oregon had 99 deaths in 2004).
2006: 342 deaths linked to methadone
In a committee meeting in December, Dr. Cordy asks whether there had been any increase in accidental overdoses of methadone and morphine since the state first made those two drugs its preferred painkillers.
Dr. Gary Franklin, medical director for L&I, says, "I guess we haven't looked at that." A Seattle Times analysis of death certificates by the state Department of Health revealed 166 deaths linked to methadone in 2003. By 2006, that number had more than doubled.
2009: 274 deaths linked to methadone
At a December committee meeting, pharmaceutical rep Bill Struyk suggests the state should do more to educate medical professionals about methadone's death toll.
Dr. Thompson pushes back, saying, "If you look at the dangers, it's not just methadone," to which Struyk says, "No. But 64 percent are."