He notes that
* Propoxyphene is a synthetic derivative of methadone.
* Methadone causes QT prolongation of questionable clinical significance in palliative care patients.
* QT prolongation is a risk factor for ventricular arrhythmias.
Combined with some FDA memo analysis (go read the post) he concludes
Well all this may be a whole lot of nothing but my real concern is that methadone may be a drug in the crosshairs of the FDA soon. It already has four strikes against it:
1) documented QT prolongation
2) stigma of heroin treatment programs
3) accelerating percent of all deaths related to opioids
4) methadone could be considered an orphan drug
This would be bad news indeed.