title: Fatal poisoning in methadone and buprenorphine treated patients -- are there differences?
abstract: BACKGROUND
  Some recent studies have suggested a lower risk of fatal intoxications in drug-dependent patients under buprenorphine compared to methadone treatment.
  
  
  METHODS
  Epidemiological reference data for the Munich region suggest that in 2003 approximately 10 % of all substitution patients were treated with buprenorphine, and 87 % with methadone. We studied the proportion of patients under methadone and buprenorphine substitution among drug-related deaths. Data from forensic post-mortem and toxicological analysis were analyzed.
  
  
  RESULTS
  Data indicate that in 96 (35 %) of all 272 so-called drug deaths, methadone was involved compared to a single case of buprenorphine, possibly indicating a relatively better risk profile of buprenorphine.
  
  
  CONCLUSIONS
  More prospective studies are necessary to assess the risk of fatal intoxications under different substitution regimens.
authors.affiliation: Psychiatric Hospital, University of Munich, Munich, Germany. Michael.soyka@med.uni-muenchen.de
authors.forename: M
authors.initials: M
authors.lastname: Soyka
authors.forename: R
authors.initials: R
authors.lastname: Penning
authors.forename: U
authors.initials: U
authors.lastname: Wittchen
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000506:poisoning*; D002423:Cause of Death; D004353:Drug Evaluation, Preclinical; D004347:Drug Interactions; D062787:Drug Overdose / Q000401:mortality*; D000431:Ethanol / Q000506:poisoning; D005260:Female; D005858:Germany; D006556:Heroin Dependence / Q000401:mortality / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000506:poisoning*; D009294:Narcotics / Q000506:poisoning*; D012189:Retrospective Studies; D012306:Risk; D015819:Substance Abuse, Intravenous / Q000401:mortality / Q000534:rehabilitation
chemical_list: D009294:Narcotics; D000431:Ethanol; D002047:Buprenorphine; D008691:Methadone