title: The source of methadone in overdose deaths in Western Virginia in 2004.
abstract: OBJECTIVE
  Methadone-related overdose deaths increased in the United States by 468% from 1999 to 2005. Current studies associate the nonmedical use of methadone with methadone-related deaths. This study describes medical examiner cases in rural Virginia in 2004 with methadone identified by toxicology and compares cases according to source of methadone.
  
  
  METHODS
  In 2004, all intentional and unintentional poisoning deaths from the Office of The Chief Medical Examiner, Western District of Virginia, were reviewed to identify cases in which methadone was a direct or contributing cause of death. The Virginia Prescription Monitoring Program was reviewed for prescription opioids in the name of these identified decedents. Decedent participation in local opioid treatment programs (OTP) was also assessed.
  
  
  RESULTS
  The source of methadone in the 61 methadone-related overdose deaths was mostly nonprescribed (67%), although 28% of decedents were prescribed methadone for analgesia. Only 5% of decedents were actively enrolled in an OTP. The majority of deaths were attributed to polysubstance overdose.
  
  
  CONCLUSIONS
  The majority of methadone overdose deaths in this study were related to illicit methadone use, rather than prescribed or OTP uses. Interventions to decrease methadone-related deaths should focus on reduction of nonprescription use of methadone.
authors.affiliation: Department of Medicine, Oregon Health and Science University, Portland, OR, USA. weimerm@ohsu.edu
authors.forename: Melissa B
authors.initials: MB
authors.lastname: Weimer
authors.forename: P Todd
authors.initials: PT
authors.lastname: Korthuis
authors.forename: George S
authors.initials: GS
authors.lastname: Behonick
authors.forename: Martha J
authors.initials: MJ
authors.lastname: Wunsch
mesh_terms: D000328:Adult; D002423:Cause of Death; D003334:Coroners and Medical Examiners; D062787:Drug Overdose / Q000401:mortality; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000506:poisoning*; D008297:Male; D008691:Methadone / Q000506:poisoning*; D009294:Narcotics / Q000506:poisoning*; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D012189:Retrospective Studies; D012424:Rural Population / Q000706:statistics & numerical data; D013405:Suicide / Q000706:statistics & numerical data; D014768:Virginia
chemical_list: D013287:Illicit Drugs; D009294:Narcotics; D008691:Methadone