title: Methadone and its role in drug-related fatalities in Cologne 1989-2000.
abstract: All drug-associated deaths from 1989 to 2000 were analysed at the Institute of Forensic Medicine in Cologne. Information concerning sex, gender, drug consumption, time, place and circumstances of death were analysed. A number of 605 cases were recorded; in 518 cases a toxicological analysis was possible and in 171 an autopsy was performed. When it was possible to determine the cause of death form the information available, acute drug intoxication was recorded in 65%. Heroin head the list of identified substances. Sixty-three percent of the specimens showed a combination of several substances, especially a combination of morphine, benzodiazepines, other medications and alcohol. In comparison with other studies the percentage of methadone-positive specimens is low, even though the proportion of specimens positive for methadone increased from 1989 to 2000. This analysis is discussed using background information concerning the management of substitution therapy and the available literature.
authors.affiliation: Institute for Legal Medicine, University of Cologne, Melatengürtel 60-62, D-50823, Cologne, Germany. hildegard.grass@medizin.uni-koeln.de
authors.forename: H
authors.initials: H
authors.lastname: Grass
authors.forename: S
authors.initials: S
authors.lastname: Behnsen
authors.forename: H-G
authors.initials: HG
authors.lastname: Kimont
authors.forename: M
authors.initials: M
authors.lastname: Staak
authors.forename: H
authors.initials: H
authors.lastname: Käferstein
mesh_terms: D001569:Benzodiazepines / Q000506:poisoning; D002423:Cause of Death; D062787:Drug Overdose / Q000453:epidemiology; D000431:Ethanol / Q000506:poisoning; D005260:Female; D005858:Germany / Q000453:epidemiology; D003932:Heroin / Q000506:poisoning*; D006801:Humans; D013287:Illicit Drugs / Q000506:poisoning*; D008297:Male; D008691:Methadone / Q000506:poisoning* / Q000627:therapeutic use; D009020:Morphine / Q000506:poisoning; D009294:Narcotics / Q000506:poisoning* / Q000627:therapeutic use; D019966:Substance-Related Disorders / Q000534:rehabilitation
chemical_list: D013287:Illicit Drugs; D009294:Narcotics; D001569:Benzodiazepines; D000431:Ethanol; D003932:Heroin; D009020:Morphine; D008691:Methadone