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Methadone dose and post-mortem blood concentration.

John R M Caplehorn1, Olaf H Drummer

  • 1School of Public Health, University of Sydney, Sydney, NSW, Australia.

Drug and Alcohol Review
|January 23, 2003
PubMed
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Post-mortem blood methadone concentrations are influenced by dose, gender, and treatment status. Methadone redistribution after death significantly elevates concentrations in deceased individuals compared to living patients.

Area of Science:

  • Forensic Toxicology
  • Pharmacokinetics
  • Clinical Pharmacology

Background:

  • Methadone is a widely used opioid agonist therapy for opioid use disorder.
  • Understanding post-mortem methadone concentrations is crucial for forensic investigations.
  • Previous studies have not fully elucidated factors influencing post-mortem methadone levels.

Purpose of the Study:

  • To investigate the relationship between methadone dose and post-mortem blood concentration.
  • To identify predictors of post-mortem blood methadone concentration.
  • To compare post-mortem methadone concentrations with estimated levels in living patients.

Main Methods:

  • Analysis of data from 1994 coronial cases in New South Wales, Australia.
  • Inclusion of data from 31 subjects with available methadone information.

Related Experiment Videos

  • Application of linear regression to identify significant predictors of post-mortem blood methadone concentration.

    • Main Results:

    • Weight-adjusted methadone dose, gender, and methadone maintenance treatment status were significant predictors.
    • An interaction between methadone maintenance treatment status and adjusted dose also predicted concentration.
    • Post-mortem concentrations in maintenance patients were significantly higher (males: ≥2x, females: ≥3x) than estimated trough levels in living patients.

    Conclusions:

    • Post-mortem methadone redistribution is likely the primary cause for elevated concentrations in deceased individuals.
    • Observed differences in post-mortem concentrations between males and females are attributed to redistribution.
    • Significant differences exist between estimated concentrations in living and deceased subjects, highlighting post-mortem redistribution effects.