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Methadone-related death in detention
1Precision Medicine, Networked Services, Bessemer Wing, King's College Hospital NHS Foundation Trust, London, SE5 9RS, UK.
Journal of Forensic and Legal Medicine
|May 2, 2022
Summary
Methadone prescriptions for detainees can prevent fatal opioid poisoning. However, early treatment deaths were linked to younger age, lower doses, and less warning signs, highlighting risks of methadone toxicity.
Area of Science:
- Forensic Toxicology
- Pharmacology
- Public Health
Background:
- Oral methadone is prescribed to detainees to reduce fatal opioid poisoning risks upon release.
- Methadone-related deaths in detention require investigation to understand contributing circumstances.
Purpose of the Study:
- To audit methadone-related deaths in detention to identify risk factors and circumstances.
- To inform strategies for minimizing unexpected deaths associated with methadone treatment in detainees.
Main Methods:
- Retrospective audit of 17 methadone-related deaths in detention between July 2010 and December 2011.
- Analysis of patient demographics, methadone dosage, post-mortem blood concentrations, and clinical observations prior to death.
Main Results:
- Deaths within 7 days of methadone initiation were associated with younger age, lower doses, and lower blood methadone concentrations.
- Warning signs like drowsiness and snoring were noted in several cases before death.
- Associated factors included pneumonia, cirrhosis, and ischemic heart disease, particularly in long-term methadone users.
Conclusions:
- Early methadone treatment deaths differ from long-term treatment deaths.
- Recognizing warning signs of methadone toxicity and associated risk factors is crucial for patient safety.
- Attention to drowsiness, snoring, and co-prescribed medications like benzodiazepines can help prevent unexpected deaths.