Methadone substitution: medicolegal problems in Germany.
In Germany, the substitution of methadone for heroin abusers has arisen recently and has resulted in various medicolegal problems. Normally, these concern methadone-associated deaths, or the prescription of methadone resulting in criminal prosecutions concerning physicians. Not to be forgotten is the problem of driving while taking methadone. In the years 1997-2001, we detected methadone in the blood of 398 cases that were analysed by the Institute of Legal Medicine, Bonn. Methadone was the only drug in only 18 cases. In most of the cases, up to five additional drugs were also being taken: benzodiazepines (61%), ethanol (40%), morphine (39%), cannabinoids (35%), cocaine (28%), anti-depressants (3%), and amphetamines (2%).
Musshoff
Frank
F
Institute of Legal Medicine, University of Bonn, Stiftsplatz 12, D-53111 Bonn, Germany. f.musshoff@uni-bonn.de
Lachenmeier
Dirk W
DW
Madea
Burkhard
B
D000293:Adolescent; D000328:Adult; D000662:Amphetamines / Q000097:blood / Q000506:poisoning; D000928:Antidepressive Agents / Q000097:blood / Q000506:poisoning; D001334:Automobile Driving; D001569:Benzodiazepines / Q000097:blood / Q000506:poisoning; D002186:Cannabinoids / Q000097:blood / Q000506:poisoning; D003042:Cocaine / Q000097:blood / Q000506:poisoning; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence*; D000431:Ethanol / Q000097:blood / Q000506:poisoning; D005260:Female; D005554:Forensic Medicine; D005858:Germany; D006801:Humans; D008297:Male; D008691:Methadone / Q000097:blood / Q000506:poisoning* / Q000627:therapeutic use*; D008875:Middle Aged; D009020:Morphine / Q000097:blood / Q000506:poisoning; D009294:Narcotics / Q000097:blood / Q000506:poisoning* / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000331:legislation & jurisprudence; D019966:Substance-Related Disorders / Q000534:rehabilitation*
D000662:Amphetamines; D000928:Antidepressive Agents; D002186:Cannabinoids; D009294:Narcotics; D001569:Benzodiazepines; D000431:Ethanol; D009020:Morphine; D003042:Cocaine; D008691:Methadone