Salt Lake actress Micaela Nelligan, 47, died two weeks before Christmas last year, a victim of "methadone toxicity." A longtime fibromyalgia sufferer, Nelligan had experienced intense pain that felt like "fire going down her legs" during the week before her death, says her sister Maire.

The family is now left trying to balance their newfound understanding of methadone's dangers with the knowledge that patients may be more concerned about ending their pain than any risk the drug poses. Referring to methadone, "Nothing else allows us to have a life" is the sentiment family members found on a fibromyalgia Web site they visited after she died.

Webster has launched a campaign he calls Zero Unintentional Deaths to educate doctors, chronic pain sufferers and the community, hoping to reduce unintentional overdose deaths while at the same time keeping drugs such as methadone available to people suffering from intractable pain.

The Utah Health Department, collaborating with other organizations, plans to kick off its own education campaign in July. The 2007 Utah Legislature provided $150,000 for each of two years to study the issue and do something about it. Methadone — which should not be confused with the illicit drug methamphetamine — first won attention for its ability to help heroin addicts kick the habit. Increasingly, however, it's being prescribed as a treatment for chronic, severe pain.

But it's the trickiest of treatments, says Dr. Robert Rolfs, the state epidemiologist, because while some medications break down and leave the body quickly, methadone, which may impair breathing, lingers an average of 16 to 50 hours. Sometimes, depending on genetics and what other drugs or foods the patient has also ingested, the drug may take up to 100 hours to clear.

That's a lot longer than the pill's pain-relieving properties, which may last only four or five hours. Patients accustomed to taking another dose of medication when the pain relief wears off — an impulse that might be fine for some painkillers — don't realize that taking another methadone pill (and maybe an extra one for good measure) may create a deadly buildup of the drug.

Physicians who transfer a patient from another type of pain relief to methadone may prescribe the wrong dose to start with, Webster says. He counsels physicians to treat the pain with something else while gradually acclimating the patient to methadone.

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Methadone, and some other drugs as well, can cause a patient to stop breathing.