- seattletimes.nwsource.com/flatpages/specialreports/methadone/methadonestollhigherinpoorerareas.html
- . http://seattletimes.nwsource.com/flatpages/specialreports/methadone/nationaldeathsandpreferreddruglists.html
- . http://seattletimes.nwsource.com/flatpages/specialreports/methadone/fataloverdosesmethadoneisno1.html
- seattletimes.nwsource.com/flatpages/specialreports/methadone/overdosedeathslinkedtomethadone.html
Provide names of other journalists involved.
Title: “Methadone and the Politics of Pain” Reporters: Michael J. Berens, Ken Armstrong Photographers: Mike Siegel, John Lok Multimedia producer: Danny Gawlowski Data analysis: Michael J. Berens, Justin Mayo Editor: James Neff Desk editor: Jerry Holloron Photo editor: Fred Nelson Print designer: Bob Warcup Graphics: Amanda Raymond, Justin Mayo Supervising producer: Tiffany Campbell Producer: Katrina Barlow Web designer/developer: Amy Richardson Additional shooting and video production: Genevieve Alvarez Researchers: David Turim, Gene Balk
List date(s) this work was published or aired.
The series was published December 11-13, 2011, in The Seattle Times, along with a December 22, 2011, follow-up.
Provide a brief synopsis of the story or stories, including any significant findings.
Part 1: “State pushes drug that saves money, costs lives” Since 2003, at least 2,173 people in Washington have fatally overdosed on methadone, a narcotic painkiller that is both cheap and unpredictable. Washington steers people with state-subsidized healthcare– most notably, Medicaid patients– toward the drug in order to save money. In terms of the drug’s toll, the poor have been hit the hardest. Medicaid recipients account for about 8 percent of Washington’s adult population but 48 percent of the methadone deaths. Year after year, a committee of state-appointed medical experts has sanctioned methadone’s use, but the committee’s deliberations have been skewed by misinformation from state officials who have a financial stake in methadone’s selection as a preferred drug. Part 2: “New law leaves patients in pain” Washington’s new pain-management law– lauded in some circles as a possible model for other states to emulate– has become a case study in unintended consequences. Passed with the intention of curbing overdose deaths, the law has driven so many medical providers from the field of pain management that many patients now struggle to find help for their chronic pain. This story chronicles the struggles of Charles Passantino, a patient with a crippling liver disease who went months without his modest prescription of oxycodone while his wife worked frantically to get him help– calling doctor after doctor, writing the governor, pleading with state officials. Part 3: “In pain clinic’s wake: doubts, chaos, deaths” A pain clinic in southwestern Washington managed to stay open for several years while prescribing potent painkillers in often extraordinary amounts. At least six people prescribed narcotics at the clinic overdosed and died. The state’s anemic response to the more than 100 complaints that rolled in against the clinic’s staff highlighted the medical community’s bitter debate about pain management and the murky landscape that regulators confront when dealing with allegations of over-prescribing.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
We made extensive use of public record requests to obtain thousands of pages of documents and large databases. This research created the backbone of the series. Primary databases: * Death certificate database: Contains dozens of pieces of information– cause of death to occupation– for tens of thousands of deaths each year. We analyzed death data going back to 1993. * Literals database: Contains text notes left by doctors, medical examiners and coroners involving each death. We analyzed these notes to obtain details about many deaths linked to methadone. * Comprehensive Hospital Abstract Reporting System: Contains data on hundreds of thousands of hospitalizations each year, including diagnosis and procedures performed as well as cost and economic status of each patient. * ARCOS database: We analyzed drug consumption data obtained by the U.S. Drug Enforcement Administration. * U.S. Census Bureau: We layered demographic data with our analysis (from death certificates and hospital data) to create multiple interactive graphics and charts. * Methadone-only deaths: We created and published (online) a customized database that showed more than 400 deaths linked only to methadone. The database was created to refute a claim by one state official that such deaths rarely occurred. Primary documents and Internet resources: * Department of Health investigative files: We obtained many thousands of state investigative files, complaint records and exhibits through public record requests. * Court records: We obtained thousands of pages of court records involving active civil suits filed against a pain clinic. * Online: We utilized websites to obtain private medical research reports, such as Medline, and a variety of government reports and studies from the FDA to SAMHSA. Also, we used online services to retrieve videos of legislative sessions. We found one state website that posted transcripts of obscure meetings that proved invaluable to the series.
Explain types of human sources used.
Initially, we were approached by several concerned physicians about the threat of unintended methadone overdose. Primarily, however, the strength of the reporting came from interviews with victims of methadone poisoning or their families. We interviewed more than 100 people, including government officials, private doctors, law enforcement officials, state regulators, attorneys, patient advocacy groups, and pain-management experts.
Results:
A week after the series was published, a committee of state-appointed medical experts decided, by unanimous vote, to issue an emergency public-health advisory singling out the risks of methadone. This warning– issued in response to The Times’ investigation– went to more than 1,000 pharmacists and drugstores, and to about 17,000 licensed health-care professionals.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
We ran a story on December 22, 2011, about the advisory mentioned in the previous answer. There have been no corrections to the series, nor has anyone come forward to challenge the stories’ factual accuracy.
Advice to other journalists planning a similar story or project.
Prepare for fierce opposition from state officials and physicians who may try to sidestep your questions. Follow the financial trail and the science. Study research reports with an eagle eye– many are flawed and incomplete, often based on unreliable estimates or surveys. Anchor the story to state records and public data (via public record requests); it’s hard for the government to refute its own records.