A Retrospective Cross-Sectional Study on Methadone Poisoning: A Decade of Insights from Kerman, Iran

Methadone poisoning, involving both syrup and tablet formulations, represents a significant public health concern, particularly in regions where methadone is widely utilized for opioid substitution therapy. Methadone accounted for approximately 16% of pediatric acute poisonings and was the leading cause of drug-related deaths in 2023. This study provides a decade-long retrospective analysis of methadone poisoning cases in Kerman, Iran, with a focus on demographic patterns, clinical outcomes, and risk factors to guide prevention and treatment strategies.

This retrospective cross-sectional study reviewed medical records of 5,826 methadone poisoning cases, primarily acute but including some chronic cases, admitted to Afzalipour Hospital between 2013 and 2023. Data on demographics, clinical presentations, comorbidities, and outcomes were analyzed using SPSS version 22, with statistical significance set at P<0.05.

The majority of patients were male (63.5%), with the highest prevalence among individuals aged 19-40 years (45.3%). Notably, 17.7% of cases involved children under six years old, primarily due to accidental ingestion linked to unsafe storage practices. Intentional poisoning accounted for 80.2% of cases, underscoring the role of mental health and socio-economic factors. Co-intoxication with benzodiazepines (9.8%) and alcohol (4.9%) exacerbated toxicity, while 8.8% of cases coincided with COVID-19 infection, compounding respiratory complications. The mortality rate was low at 1.9% (95% CI: 1.6-2.2%), with 63.8% of cases achieving full recovery; and notably, 17.7% of cases involved were children aged under six years old.

The findings, including high co-intoxication risks with benzodiazepines (9.8%) and alcohol (4.9%), highlight the urgent need for targeted interventions, including stricter regulation of methadone distribution, childproof packaging, and public education campaigns to reduce accidental pediatric poisonings. Integrated mental health services are critical to addressing intentional poisoning cases (80.2%), while healthcare providers should remain vigilant about polysubstance use. These strategies can significantly reduce methadone-related morbidity and mortality, especially among vulnerable populations such as children and young adults.