What is it about?
This paper follows hospital mortalities due to suspected methadone toxicity, looking for real cause of death in this group through postmortem examination and analysis. In a total of 94 patients, autopsy findings and laboratory evaluations showed that cause of death was pure methadone toxicity in 57 (60.6%). Other causes of death were ischaemic heart disease in ten, co-ingestions (toxicities including methadone) in eight, brain haemorrhage, multi-organ failure and pneumosepsis (each in four), meningitis/encephalitis in three and head trauma and other toxicities (other than methadone but including an opioid, each in two) patients.
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Why is it important?
Our finding show that in methadone users, especially in older ages and those with trivial response to naloxone administration, loss of consciousness should not be strictly attributed to methadone toxicity. In such patients, thorough evaluation for other possible causes of loss of consciousness is mandatory.
Perspectives
As the number of legal opioid related deaths is increasing, the result of current study can clarify some important aspects of methadone toxicity. In my mind, although methadone is used for its long half-life for maintenance therapy, but this long half life can cause mortality when people are intoxicated. I hope you find this article thought-provoking and choose the best opioid for each patient.
Dr Hossein Hassanian-Moghaddam
Shahid Beheshti University of Medical Sciences
Read the Original
This page is a summary of: Suspected Methadone Toxicity: from Hospital to Autopsy Bed, Basic & Clinical Pharmacology & Toxicology, July 2017, Wiley,
DOI: 10.1111/bcpt.12831.
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