Letters

Letters 07-21-2014

Disheartened

While observing Fox News, it was disheartening to see what their viewers were subjected to. It seems the Republicans’ far right wing extremists are conveying their idealistic visions against various nationalities, social diversities or political beliefs with an absence of emotion concerning women’s health issues, children’s rights, voter suppression, Seniors, Social Security, Medicare and Medicaid...

Things That Matter

All of us in small towns and large not only have the right to speak on behalf of our neighbors and ourselves, we have the duty and responsibility to do so -- and 238 years ago, we made a clear Declaration to do just that...

An Anecdote Driven Mind

So, is Thomas Kachadurian now the Northern Express’ official resident ranter? His recent factfree, hard-hearted column suggests it. While others complain about the poor condition of Michigan’s roads and highways, he rants against those we employ to fix them...

No On Prop 1

Are we being conned? Are those urging us to say “yes” to supposedly ”revenue neutral” ballot proposal 1 on August 5 telling us all the pertinent facts? Proposal 1 would eliminate the personal property tax businesses pay to local governments, replacing its revenue with a share of Michigan’s 6 percent use tax paid by us all on out-of-state purchases, hotel accommodations, some equipment rentals, and telecommunications...

Fix VA Tragedy

The problems within the Veterans Administration identified under former President Bush continue to hinder the delivery of quality health care to the influx of physically wounded and emotionally damaged young men and women...

Women Take Note

I find an interesting link between the Supreme Court Hobby Lobby and the crisis on the southern border. Angry protesters shout at children to go home. These children are scared, tired, hungry and thirsty, sent to US prisons awaiting deportation to a country where they may very likely be killed...


Home · Articles · News · Features · Methadone
. . . .

Methadone

Anne Stanton - March 15th, 2010
Methadone:the quiet killer
Daniel Pagel, at the age of 21, wasin a downward spiral of his short life. Formerly a fun-lovingsnowboarder, his deepening addiction to drugs wascrushing him.
On the night of February 8, he was partying with a couple of friendsinto the early morning hours. When Pagel’s fatherchecked on him inthe morning, he was acting erratically, crying over hisdog that hadbeen put in the pound. His dad went to work, leaving Pagel with afriend to watch  him. He died later that morning, asleep in bed, atabout 10:50 a.m.
Although autopsy results have not been published, there were two
wafers of methadone at the scene, along with Xanex tablets, and
hypodermic needles, suggesting that he had injected methadone, a
common painkiller usually taken in pill form.
Methadone is a very effective drug for acute pain, but it can also
quietly kill people in their sleep. While many deaths are suffered by
illicit drug users,  others are bona fide patients who have not used
methadone as prescribed. Even when used as prescribed, deaths have
occurred, according to published media reports.
Historically, methadone was used in treatment centers to help reduce
an addict’s craving for heroin.  But about seven years ago, doctors
began to use methadone for pain. The medical community—pressured by
law enforcement to find an alternative to OxyContin, which gives an
immediate “high”—thought the slower acting methadone was a better
alternative.
 “I’ll first tell you what’s good about methadone,” said Terry
Baumann, a Munson Medical Center pharmacist, who specializes in pain
control. “When it comes to pain control, it affects a broader range of
pain receptors than other opioids. So it’s very effective for severe
pain.  It’s another tool in your tool box. On top of that, it’s very
inexpensive.”

SLOW DEATH
But its slow-acting nature is also its downfall and has contributed to
a three-fold increase in prescription drug overdoses in the area since
2000, said Lieutenant Detective Ken Mills, who oversees SANE (Straits
Area Narcotics Enforcement), a multi-jurisdictional task force that
oversees seven counties, including Emmet and Charlevoix counties.
“When somebody doesn’t feel the effects right away, they will take
one, then another one, and maybe a third one, and, boom, it hits them
all at once.” An overdosed patient essentially suffocates, with the
brain unable to instruct the body to breathe,  he said.
“That can be reversed with an emergency antidote, but not after you
quit breathing obviously,” Baumann said.
Methadone also has a very long half-life,  a measure of how long half
the drug dose stays in the system once it’s taken.
“If I take a drug like Percocet, it gets out of my system quite
quickly.  A drug like methadone takes a long time to get out of your
system, anywhere from 18 to 60 hours. That’s another problem. A doctor
can’t tell by looking at you if you are a 60-hour person or if you are
an 18-hour person,” Baumann said.
So if a person who has just started taking methadone doesn’t feel any
pain relief, a doctor might mistakenly increase it too much without
taking into account the drug’s  half life, he said.
Other fatal flaws: The drug is unforgiving when mixed with other
drugs, such as Xanex, alcohol, or even antacids. Doses also climb over
time to achieve the same pain-relieving effect; so a high dose pill
can easily kill someone who’s “narcotic naïve.” It’s also very tricky
to switch a patient from one opiate to methadone, requiring adherence
to exact ratios, Baumann said.
“Within the last couple years, as we’ve seen the (death) stats, the
medical community has met and talked about this. We need to make sure
we understand this,” Baumann said.
PRESCRIPTION MENACE
Pagel’s death occurred within days of an Express article, reporting
that a record 10 students have been expelled in the Traverse City
public schools—most for selling prescription drugs.
“Very good article,” wrote Dan Pagel’s sister, Amy Pagel, in response.
“However, this obviously is not just a problem with middle school or
high school kids... It is a starting point for most though. Also, it
is not just kids rifling through their parents’ medicine cabinets that
we need to worry about. Prescription pills should be locked away, not
just from kids... but anyone and everyone who does not need them.
There are many adults that get prescribed these drugs and just sell
them to kids for extra cash. I know this because my brother died last
week from a methadone overdose... My parents do not take this ungodly,
unnatural, man-made chemical. He was being supplied by a cancer
patient.”
Amy was right. According to the state Department of Community Health,
most who die from drug-induced deaths are in the age group of 45 to
49. In fact, the numbers are staggering—809 died in this middle-age
group compared to 92 deaths, ages 15 to 19, in the years 2000-2007.

DEATH SPIKE
“When we saw the availability of methadone on the street in 2003, we
knew at that time, we’d see a spike in deaths from methadone,” Mills
said.
In fact, accidental drug overdose deaths increased from 7 to 37 in
Antrim, Alpena, Charlevoix, Cheboygan, Emmett, Grand Traverse,
Montmorency, Otsego and Presque Isle counties from 2000 to 2007.
Statewide, in the same time period, deaths increased from 295 to 848,
according to the Department of Community Health.
On average, about one person dies each month from a prescription
overdose in Benzie, Leelanau, and Grand Traverse counties,  compared
to three deaths total in 2000, said Grand Traverse County Medical
Examiner Matthew Houghton.
“It was amazing how they took off,” Mills said. “These stats don’t
tell you what  specific prescription medicine caused the overdose is,
but just knowing what we know, the availability of methadone, we knew
we’d see an increase in deaths.”
Munson Medical Center statistics show that 715 people were poisoned by
a wide range of prescription drugs, including 57 from alcohol, from
2004 to 2008. The vast majority of poisonings were due to psychotropic
drugs and opiates.
NO FRIEND AT ALL
Sharon Mitchell lost her 17-year-old son, Nick Eickenroth, on August
10, 2005. She remembers on his last day alive, he had called her from
the house of Sherry, a 15-year-old friend in Kingsley (not her real
name).
 “He called me at Munson at 1:30 p.m., he sounded fine. I told him,
when he called, that I’d be there to pick him up. And I scolded him,
‘Don’t call me unless it’s an emergency.’ That was our last
conversation. I said, ‘I love you, and I’ll see you later.’”
The next call came from Sherry’s mother at 6:45 p.m., telling her that
Nick had died. When she arrived at Sherry’s house, it had been taped
off by police. “They wouldn’t let anyone in there for 2 1/2 hours
until the medical examiner got there,” said David Eickenroth, Nick’s
father.
David later found out that both Sherry and her mother had methadone
prescriptions.  In fact, Sherry had been expelled for selling drugs on
the bus, while her mother had been fired from Munson for stealing
prescription drugs.
David surmised they were having a methadone party, but he’ll never
know the truth. The Traverse City Michigan State Police officer
allowed Sherry and her mother to sit together and write their
statements; they claimed that Nick stole the methadone from the
medicine cabinet.  The police never investigated whether Sherry and
her mother had drugs in their blood system. The police did not return
a call for comment, and a FOIA request was denied, with the Lansing
office unable to locate a report.
“I think the police could have done more,” said Nick’s sister, Naomi
Dillingham. “I think they thought Nick was a drug addict. We can’t
blame anyone for what he did, but I think the police failed him.”
The family, in deep grief, researched methadone and decided to speak
to the schools about its dangers. Sharon called the Kingsley
principal, Terry Street, who has since retired. When he finally
accepted the call, he refused her offer to speak. “He said it would be
too hard for us, but I told him, ‘I’d already spoken at two other
schools,’” she said.
Some 500 people attended Nick’s funeral, not surprising considering he
was a very popular athlete.
“We had no idea he was taking drugs,” said another sister, Emily
Davey. “He was the number one BMX racer in the state of Michigan. He
was super athletic with two track records at Kingsley, he was amazing,
super quick. I don’t know how he could have been performing at that
level, if he’d been taking drugs.”

REWIRING
One of the difficulties of addiction is that opiates rewire the brain,
allowing a disconnect between judgment and a sense of right and wrong.
The mid-brain, or the more primitive part of the brain, begins to
assume control, said Dr. Richard Entz, medical director of Munson’s
Alcohol and Drug Treatment center,  in a video published on Munson’s
website.
Scott Pagel, Dan’s 25-year-old brother, said that he saw his brother’s
judgment deeply deteriorate.  “One time, we went to Tilley’s Party
Store, and he stole Frisbee golf discs from them. I called him out on
it, and he got all pissed off. He thought he was totally in the right,
he had no clue. He had no sense of right and wrong.”
He began stealing, and his old, “good” friends couldn’t trust him
anymore. Scott, who was able to shake his own drug addiction thanks to
a downstate book camp. But Dan refused help, thinking he could handle
it on his own.  Meanwhile,  his dad was  in denial over what was
happening, he said.
“He did overdose back in September on methadone,” said Dan’s mom,
Marianne, who lives in Marquette. “They just released him from the
hospital. They didn’t put him through rehab, nothing, because he
didn’t have insurance.  This is one of the kids, who fell through the
cracks. He never should have.”
“He’d been clean for a week or two, and then on the night he died, he
took his normal dose, and his body wasn’t used to his normal dose,”
Scott Pagel said. “If he took Xanex and methadone, both are
respiratory suppressants. Your breathing just slows and slows and
slows, the higher you get.  His lungs just shut down from the system.
His body was so relaxed, it quit functioning.
“These people need to be kept from themselves; you reach a certain
point on this addiction where you are not in control anymore. I cut
the tip of my finger actually and picked up opiates for the pain on my
finger. Just the two or three days I was on it, I’m not even joking,
there were voices in my head, telling me to get more. This shit, for
someone in his situation for three years plus, I can only imagine,”
said Scott, who added that marijuana is a much safer pain reliever.

IN MEMORY
Despite his tragic end, the Facebook page, “In Memory of Dan Pagel,”
reveals a wealth of friends.
“I think everyone is at a loss. He was a genuinely bright happy person
to be around. He just made you happy and all the people around him,”
said his friend, Rachel Hemstreet, 21. “But it wasn’t a secret what
Dan did. We had a lot of discussions about it. There was a time he
told me that he didn’t want to die. He had a bad addiction and he knew
what that meant. We all cared, and he knew that too.  I don’t think
there was anything you can really do for people who want to keep doing
things.”
Although Pagel seemed happy, he was on a rough road.
“The last job he had was at Target for seasonal help and then they let
him go,” said his sister Amy. “He just had a hard time; he never had a
ride anywhere. He couldn’t get a car, he didn’t have his driver’s
license. It was suspended for speeding tickets, then he drove on a
suspended license, and his license was taken away for driving again.
He owed the court $4,000 or $5,000, some insane amount. It was
impossible for him to get a job, with no car, no license. The court
system was bringing him down, he owed them so much. He was stuck in a
rut with no hope of getting out.
“The sad thing is, he was planning on moving that Friday to get a job
down there, start over and start fresh—he didn’t get that chance.
Who’s to say it couldn’t have happened down there?”

TERRIBLE SHAME
Stacy Salon, who was featured in the Munson video with Entz, said she
was 36 when she received a pain prescription, Norco, for shoulder pain
in 2006. The medication, although not methadone,  is similar to all
opiates; to get the same effect, it’s necessary to continually
increase the dose.
“After about a year in, if I didn’t take a pill every four hours, I
felt like I almost had the flu,” she said.
After awhile, she felt emotionally numb to her children and her
husband. “Everything that was happy I was destroying.  … I was getting
pills from my doctor for 2 1/2 years, and then I went off from them,
and didn’t want to feel the feelings, so I started forging
prescriptions from him. I did that for six months until I got caught.
And then I was sentenced to sobriety court,” she told the Express.
Salon of Traverse City said that she felt terrible shame about her
addiction before seeking treatment at Munson. A doctor’s wife, she had
been a straight-A student and a college graduate.
“I am so unbelievably grateful to Munson,” she said. “I’m such a
different person today. I’m almost grateful for it, if it makes any
sense at all. I chair Narcotics Anonymous meetings, and the people in
the meetings say they weren’t sentenced;  they were saved.  I
completely agree. When I was sentenced to sobriety court, it changed
me, even before my using.
“I love myself today, I have faith in myself, I know how unbelievably
strong I am today. I’ve lost 120 pounds. I’m like a whole new person
because of the love for myself today. And I don’t know how I’d gotten
there, without the assignments for Munson, all the things I had to do
for sobriety court. It’s been such a journey, other than being
arrested, I wouldn’t change any of it.”

Next week: Former Judge Thomas Gilbert’s thoughts on how to help save addicts.

 
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