title: Therapeutic and recreational methadone cardiotoxicity.
abstract: Several classes of drugs have been associated with an increased risk of cardiovascular disease and occurrence of arrhythmias potentially involved in sudden deaths in chronic users even at therapeutic doses. The study presented herein focuses on pathological changes involving the heart possibly due to methadone use. 60 cases were included in the study in total and were divided into three groups (therapeutic methadone users: 20 cases, recreational methadone users: 20 cases, and sudden death group in subjects who had never taken methadone: 20 cases). Autopsies, histology, biochemistry and toxicology were performed in all cases. Macroscopic and microscopic investigation results in therapeutic methadone users were similar to those observed in sudden, unexpected deaths in non-methadone users. In recreational methadone consumers, macroscopic and microscopic examination of the heart failed to provide results consistent with acute or chronic myocardial or coronary damage, thereby corroborating the hypothesis of death most likely following respiratory depression.
authors: Department of Diagnostic Medicine, Clinical and Public Health, University of Modena and Reggio Emilia - Section of Legal Medicine, Modena, Italy.
authors: Monia
authors: M
authors: Lusetti
authors: Department of Diagnostic Medicine, Clinical and Public Health, University of Modena and Reggio Emilia - Section of Legal Medicine, Modena, Italy.
authors: Manuela
authors: M
authors: Licata
authors: Department of Diagnostic Medicine, Clinical and Public Health, University of Modena and Reggio Emilia - Section of Legal Medicine, Modena, Italy.
authors: Enrico
authors: E
authors: Silingardi
authors: Department of Diagnostic Medicine, Clinical and Public Health, University of Modena and Reggio Emilia - Section of Clinical Pathology, Modena, Italy.
authors: Luca
authors: L
authors: Reggiani Bonetti
authors: University Center of Legal Medicine, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: cristian.palmiere@chuv.ch.
authors: Cristian
authors: C
authors: Palmiere
mesh_terms: D000328:Adult; D066126:Cardiotoxicity; D016757:Death, Sudden, Cardiac / Q000209:etiology; D053593:Forensic Toxicology; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D009206:Myocardium / Q000473:pathology*; D009294:Narcotics / Q000009:adverse effects* / Q000097:blood; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000401:mortality / Q000534:rehabilitation; D012189:Retrospective Studies
chemical_list: D009294:Narcotics; D008691:Methadone
keywords: Arrhythmia; Autopsy; Forensic science; Methadone; Sudden death; Toxicology