Methadone intoxications and methadone-related deaths during a five-year period in Vojvodina, Serbia

Background: Methadone is a synthetic long-acting opioid, most commonly used as an oral solution in medical treatment of heroin addiction. The use of methadone as well as concomitant medication may lead to accidental or intentional intoxication, as well as methadone-related death. Aim: The aim of this study was to analyze all methadone-related intoxications and methadone-related deaths during a five year period (2011-2015) at the Clinical Centre of Vojvodina. Methods: Patient data was retrospectively collected and analyzed from medical records at the Emergency Room and Centre for Forensic Medicine of the Clinical Centre of Vojvodina. Results: During the monitored period 156 patients were treated for methadone intoxication, while 55 deaths were pronounced MRDs. Most of the patients in both groups were male, around 33 years old. In both groups toxicology revealed that the majority of patients took concomitant benzodiazepines, as well as other medications. Opiate intoxication were on the rise from 2011 through 2014, with stagnation in 2015. The percentage of MRDs in opiate related deaths ranged from 42 to 77%. Histopathology releaved both acute myocardial and chronic liver damage in most MRDs. Conclusions: The use of methadone and concomitant medication in treatment of heroin addiction, as well as illegal use carries risk of both overdose and death. Young males are a particularly high risk group. The number of opiate, and methadone intoxications has been on the rise from 2011 to 2014, with stagnation in 2015. MRDs have accounted for around 50% of ORDs in 2013-2015.