Methadone-related deaths in Norway

Forensic Sci Int. 2013 Jan 10;224(1-3):111-6. doi: 10.1016/j.forsciint.2012.11.010. Epub 2012 Dec 13.

Abstract

Introduction: The use of methadone in opioid maintenance treatment (OMT) is potentially associated with a number of adverse effects and the risk of fatal toxicity. Increased methadone availability may lead to an increase in methadone-related deaths. We have investigated methadone-related deaths in Norway over the period 2000-2006.

Materials and methods: Methadone-positive samples over the period 2000-2006 were identified from forensic toxicological investigations, and demographic and toxicological data were retrieved. The cases were cross-linked with the Norwegian Cause of Death Registry and regional OMT registers.

Results: A total of 312 individuals had died after taking methadone over the period 2000-2006, predominantly men with a mean age of 36. In 85% of cases (n=264), the deceased had died of a methadone-related intoxication, most often in combination with other drugs, including benzodiazepines, cannabis and other opioids. Only 22% of the deceased had been in OMT at the time of death. A larger proportion of OMT patients had died of causes other than intoxications compared to those not in OMT (30% vs. 8%, respectively), most commonly related to disease.

Conclusions: One methadone-related death occurred, on average, every week over the time period investigated. Only 22% of the deceased were registered in opioid maintenance treatment (OMT) programs. The findings underline the need to control diversion of medication from OMT programs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents / mortality
  • Adult
  • Benzodiazepines / blood
  • Cause of Death
  • Dronabinol / blood
  • Female
  • Forensic Toxicology
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Male
  • Methadone / blood
  • Methadone / poisoning*
  • Narcotics / blood
  • Narcotics / poisoning*
  • Norway / epidemiology
  • Registries
  • Substance-Related Disorders / mortality
  • Suicide / statistics & numerical data

Substances

  • Narcotics
  • Benzodiazepines
  • Dronabinol
  • Methadone