title: Methadone-related deaths in Montpellier and Region, from 2000 to 2010.
abstract: OBJECTIVE
  The objectives of this analysis were to assess the role of methadone and related substances in death occurring, discussing methadone blood concentrations and the contribution of the autopsy to the accountability of methadone in the death process.
  
  
  METHODS
  We retrospectively analyzed all forensic cases positive for methadone from January 2000 to December 2010, in Montpellier and the region served by our laboratory.
  
  
  RESULTS
  During the study period, 64 cases of deaths (11 women, 53 men) with methadone detection were recorded. A progressive increase between 2001 (2 cases) and 2010 (8 cases) was observed. The median age was 33 years old. An autopsy was available in 56.3% of cases. The most frequent finding at the autopsy was non-specific asphyxia death signs (67.6%). Tolerance to opioids was documented in 21 cases. The methadone blood concentrations ranged from 1 to 2 800 ng/mL (59 cases, median value 330 ng/mL). Most of the cases (88%) were polydrug intoxications. The most commonly associated drugs were benzodiazepines (61%), cannabinoids (28%), opioids (19%) and cocaine (12.5%).
  
  
  CONCLUSIONS
  During a 11-year period, toxicological analyses related to 1991 death cases were performed at the Toxicology Laboratory of Montpellier University Hospital. Of these patients, 64 deaths were possibly related to methadone. Several relevant elements (biological analysis and autopsy) were used to attribute the deaths to the sole methadone (12 cases) or to methadone and associated substances (8 cases).
authors.affiliation: Département de Pharmacologie médicale et Toxicologie, Hôpital Lapeyronie, CHU Montpellier, Montpellier, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Eiden
authors.forename: Philippe
authors.initials: P
authors.lastname: Cathala
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Mathieu-Daude
authors.forename: Benjamin
authors.initials: B
authors.lastname: Marson
authors.forename: Eric
authors.initials: E
authors.lastname: Baccino
authors.forename: Yves
authors.initials: Y
authors.lastname: Leglise
authors.forename: Hélène
authors.initials: H
authors.lastname: Peyrière
mesh_terms: D000328:Adult; D001344:Autopsy; D002423:Cause of Death; D062787:Drug Overdose / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008691:Methadone / Q000097:blood / Q000506:poisoning*; D009294:Narcotics / Q000097:blood / Q000506:poisoning; D009994:Osmolar Concentration; D012189:Retrospective Studies
chemical_list: D009294:Narcotics; D008691:Methadone