Fatal poisoning in methadone and buprenorphine treated patients -- are there differences?
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.
Soyka
M
M
Psychiatric Hospital, University of Munich, Munich, Germany. Michael.soyka@med.uni-muenchen.de
Penning
R
R
Wittchen
U
U
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
D009294:Narcotics; D000431:Ethanol; D002047:Buprenorphine; D008691:Methadone