A comparison of drug overdose deaths involving methadone and other opioid analgesics in West Virginia.
OBJECTIVE
To describe all people dying from unintentional overdoses of methadone or other opioid analgesics (OOA) in West Virginia in 2006.


METHODS
We analyzed medical examiner data supplemented by data from the state prescription drug monitoring program. We compared people whose deaths involved methadone with those whose deaths involved OOA.


RESULTS
The methadone group included 87 decedents, and the OOA group included 163 decedents. Most were male. Decedents in the methadone group were significantly younger than those in the OOA group: more than a quarter were 18-24 years of age. For both groups, approximately 50% had a history of pain, and 80% had a history of substance abuse. There was no intergroup difference in the prevalence of benzodiazepines at post-mortem. Methadone was significantly less likely to have ever been prescribed than OOA. Among those with prescriptions, the proportion prescribed within 30 days of death was significantly greater for methadone than for hydrocodone, but not for oxycodone. Ten (11.5%) of the methadone decedents were enrolled in an opiate treatment program (OTP) at the time of death.


CONCLUSIONS
The high prevalence of a substance abuse history and lack of prescriptions suggest that most of the deaths in both groups are related to substance abuse. There was no indication of a harmful effect from methadone's metabolic interaction with benzodiazepines, but provider or patient unfamiliarity with methadone may have been a risk factor. Prescribing methadone, especially to young males, requires extra care. Providers, OTPs and coroners/medical examiners should use state prescription drug monitoring programs to monitor the use of controlled substances by their patients.
Paulozzi
Leonard J
LJ
National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-62, Atlanta, GA 30341-3717, USA. lbp4@cdc.gov
Logan
Joseph E
JE
Hall
Aron J
AJ
McKinstry
Edna
E
Kaplan
James A
JA
Crosby
Alexander E
AE
D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000506:poisoning*; D002423:Cause of Death; D062787:Drug Overdose / Q000453:epidemiology / Q000401:mortality; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D053593:Forensic Toxicology; D006556:Heroin Dependence / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage; D008875:Middle Aged; D014903:West Virginia / Q000453:epidemiology; D055815:Young Adult
D000701:Analgesics, Opioid; D008691:Methadone