title: Methadone-related deaths in Norway.
abstract: BACKGROUND
  The use of methadone in opioid maintenance treatment (OMT) is potentially associated with a number of adverse effects and the risk of fatal toxicity. Increased methadone availability may lead to an increase in methadone-related deaths. We have investigated methadone-related deaths in Norway over the period 2000-2006.
  
  
  METHODS
  Methadone-positive samples over the period 2000-2006 were identified from forensic toxicological investigations, and demographic and toxicological data were retrieved. The cases were cross-linked with the Norwegian Cause of Death Registry and regional OMT registers.
  
  
  RESULTS
  A total of 312 individuals had died after taking methadone over the period 2000-2006, predominantly men with a mean age of 36. In 85% of cases (n=264), the deceased had died of a methadone-related intoxication, most often in combination with other drugs, including benzodiazepines, cannabis and other opioids. Only 22% of the deceased had been in OMT at the time of death. A larger proportion of OMT patients had died of causes other than intoxications compared to those not in OMT (30% vs. 8%, respectively), most commonly related to disease.
  
  
  CONCLUSIONS
  One methadone-related death occurred, on average, every week over the time period investigated. Only 22% of the deceased were registered in opioid maintenance treatment (OMT) programs. The findings underline the need to control diversion of medication from OMT programs.
authors.affiliation: Norwegian Institute of Public Health, Division of Forensic Medicine and Drug Abuse Research, Oslo, Norway. jpbern28@hotmail.com
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Bernard
authors.forename: Ingrid
authors.initials: I
authors.lastname: Havnes
authors.forename: Lars
authors.initials: L
authors.lastname: Slørdal
authors.forename: Helge
authors.initials: H
authors.lastname: Waal
authors.forename: Jørg
authors.initials: J
authors.lastname: Mørland
authors.forename: Hassan Z
authors.initials: HZ
authors.lastname: Khiabani
mesh_terms: D000059:Accidents / Q000401:mortality; D000328:Adult; D001569:Benzodiazepines / Q000097:blood; D002423:Cause of Death; D013759:Dronabinol / Q000097:blood; D005260:Female; D053593:Forensic Toxicology; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D008297:Male; D008691:Methadone / Q000097:blood / Q000506:poisoning*; D009294:Narcotics / Q000097:blood / Q000506:poisoning*; D009664:Norway / Q000453:epidemiology; D012042:Registries; D019966:Substance-Related Disorders / Q000401:mortality; D013405:Suicide / Q000706:statistics & numerical data
chemical_list: D009294:Narcotics; D001569:Benzodiazepines; D013759:Dronabinol; D008691:Methadone