Abstract
Methadone has a long and successful history in the treatment of opioid addiction. In recent years, it has become popular again—as potent and inexpensive analgesic in patients with chronic pain. Since methadone has been used fatalities have been reported. In our study all methadone-associated deaths in Zurich from 1998 to 2007 were analysed. Most of the 146 detected deaths of the past 10 years occurred during substitution programmes or illicit intake of methadone while only three of them could be attributed to methadone used as an analgesic. Noticeable in our study was the high percentage of cases of combined drug intoxication (76%). The most frequent co-intoxicants were alcohol and cocaine. Mortalities attributed to methadone intoxication alone were a rare finding and could only be detected in five cases of deceased who had received methadone maintenance treatment. The aim of our study is to assess the trends in the number and nature of methadone-related fatalities in Zurich during the last 19 years. For this purpose a previous study from Zurich (1989–1997) was included, whereby a very long observation period and large number of cases resulted.
Similar content being viewed by others
References
Shields LBE, Hunsaker JC, Corey TS, Ward MK, Stewart D (2007) Methadone toxicity fatalities: a review of medical examiner cases in a large metropolitan area. J Forensic Sci 52(6):1389–1395
Chugh SS, Socoteanu C, Reinier K, Waltz J, Jui J, Gunson K (2008) A community-based evaluation of sudden death associated with therapeutic levels of methadone. Am J Med 121:66–71
Perret G, Dédlon J-J, Kreek MJ, Ho A, Harpe RL (2000) Lethal methadone intoxications in Geneva, Switzerland, from 1994 to 1998. Addiction 95(11):1647–1653
Wolf BC, Lavezzi WA, Sullivan LM, Flannagan LM (2004) Methadone related deaths in Palm beach county. J Forensic Sci 49(2):375–378
Soyka M, Apelt SM, Lieb M, Wittchen HU (2006) One-year mortality rates of patients receiving methadone and buprenorphine maintenance therapy: a nationally representative cohort study in 2694 patients. J Clin Psychopharmacol 26(6):657–660
Pirnay S, Borron SW, Giudicelli CP, Tourneau J, Baud FJ, Ricordel I (2004) A critical review of the causes of death among post-mortem toxicological investigations: analysis of 34 buprenorphine-associated and 35 methadone-associated death. Addiction 99:978–988
Dobler-Mikola A, Pfeifer S, Müller V, Uchtenhagen A (2000) Vergleich Methadon- und Heroinverschreibungen in der Schweiz. Suchttherapie 1:63–66
Musshoff F, Lachenmeier K, Lichtermann D, Madea B (2008) Cocaine and opiate concentrations in hair from subjects in a heroin maintenance program in comparison to a methadone substitutes group. Int J Legal Med 123:363–369
Bundesamt für Gesundheit (2007) Nationale Methadonstatistik 1999–2007. Schweizerische Eidgenossenschaft, Bundesamt für Gesundheit, Bern
U.S. Department Of Health And Human Services (2004) Methadone-associated mortality: report of a national assessment. Substance abuse and mental health services administration. Center for Substance Abuse Treatment, Rockville
Cook DS, Braithwaite RA, Hale KA (2009) Estimating antemortem drug concentrations from postmortem blood samples: the influence of postmortem redistribution. J Clin Pathol 53:282–285
Drasch G, Dahlmann F, Meyer LV, Roider G, Eisenmenger W (2008) Frequency of different anti-depressants associated with suicides and drug death. Int J Legal Med 122:115–121
Fugelstad A, Stenbacka M, Leifman A, Nylander M, Thiblin I (2007) Methadone maintenance treatment: the balance between life-saving treatment and fatal poisonings. Addiction 102(3):406–412
Graß H, Behnsen S, Kimont H-G, Staak M, Käferstein H (2003) Methadone and its role in drug-related fatalities in Cologne 1989–2000. Forensic Sci Int 132:195–200
Hauri-Bionda R, Bär W, Friedrich-Koch A (1999) Methadon bei außergewöhnlichen Todesfällen, Zürich 1989–1997. Rechtsmedizin 9:94–98
Jensen S, Gregersen M (1991) Fatal poisoning with intravenously injected methadone and no fresh injection mark found. Int J Legal Med 104:299–301
Kaa E, Teige B (1993) Drug-related deaths during the 1980 s. Int J Legal Med 106:5–9
Kim HK, Manini A (2008) Methadone-associated sudden cardiac death? Am J Med 121(9):e11
Levine B, Wu SC, Dixon A, Smialek J (1995) Site dependence of postmortem blood methadone concentrations. Am J Forensic Med Pathol 16:97–100
Maag V (2006) Kokain—die neue Volksdroge? Nationale und internationale Trends. Abhängigkeiten 1:13–22
Milroy CM, Forrest ARW (2009) Methadone deaths: a toxicological analysis. J Clin Pathol 53:277–281
Steentoft A, Worm K, Pedersen CB, Sprehn M, Morgensen T, Sorensen MB, Nielsen E (1996) Drugs in blood samples from unconscious drug addicts after the intake of an overdose. Int J Legal Med 108:248–251
Worm K, Steentoft A, Kringsholm B (1993) Methadone and drug addicts. Int J Legal Med 106:119–123
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Laberke, P.J., Bartsch, C. Trends in methadone-related deaths in Zurich. Int J Legal Med 124, 381–385 (2010). https://doi.org/10.1007/s00414-010-0442-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00414-010-0442-8