[Deaths associated with methadone]

Used as early as 1946 as an analgesic then to treat heroin addicts, the addicting and toxic potential of methadone was quickly recognized. 25 deaths between 1981 and 1986 were reportedly due to methadone in Geneva of which 2 were violent deaths, 9 were caused by a combination of opiates and methadone and 14 were directly related to methadone. Three deaths were noted during the two first weeks of methadone substitutive therapy. Six were noted less than two weeks before leaving jail and 15 were associated with benzodiazepine ingestion. Postmortem blood levels cannot help determine the severity of poisoning neither a causal relationship between methadone and death. Pathological findings as well as the medical history should be taken into consideration.