Deaths in the first two weeks of maintenance treatment in NSW in 1994: Identifying cases of iatrogenic methadone toxicity
A study was undertaken to estimate the frequency of iatrogenic methadone toxicity in the first 2 weeks of maintenance treatment in NSW. Cases were identified from a list of all 1994 methadone-associated deaths using data on methadone patients held by the NSW and Queensland Health Departments. The li...
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Veröffentlicht in: | Drug and alcohol review 1998-03, Vol.17 (1), p.9-17 |
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description | A study was undertaken to estimate the frequency of iatrogenic methadone toxicity in the first 2 weeks of maintenance treatment in NSW. Cases were identified from a list of all 1994 methadone-associated deaths using data on methadone patients held by the NSW and Queensland Health Departments. The likely causes of death were determined from data collected from coronial files. A forensic toxicologist experienced in the area gave an independent opinion. Of the 14 deaths in the first 2 weeks of maintenance, at least 10 were primarily caused by the toxic effects of methadone prescribed by NSW doctors. The rate of fatal iatrogenic methadone toxicity was 2.2 per thousand admissions to maintenance. Victims of fatal iatrogenic toxicity often displayed signs of methadone intoxication in the days before their death. They invariably died several hours after taking the fatal dose, usually after seeming to go to sleep. Often friends or family were concerned about their welfare, were unable to rouse them from their "sleep" and frequently reported the deceased was "snoring" loudly for some time before their demise. The author recommends that patients entering methadone maintenance should be informed of the risks and should be required to give written consent to treatment. To prevent fatal methadone toxicity, patients should receive daily medical assessment during the first 1-2 weeks of maintenance. |
doi_str_mv | 10.1080/09595239800187551 |
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Cases were identified from a list of all 1994 methadone-associated deaths using data on methadone patients held by the NSW and Queensland Health Departments. The likely causes of death were determined from data collected from coronial files. A forensic toxicologist experienced in the area gave an independent opinion. Of the 14 deaths in the first 2 weeks of maintenance, at least 10 were primarily caused by the toxic effects of methadone prescribed by NSW doctors. The rate of fatal iatrogenic methadone toxicity was 2.2 per thousand admissions to maintenance. Victims of fatal iatrogenic toxicity often displayed signs of methadone intoxication in the days before their death. They invariably died several hours after taking the fatal dose, usually after seeming to go to sleep. Often friends or family were concerned about their welfare, were unable to rouse them from their "sleep" and frequently reported the deceased was "snoring" loudly for some time before their demise. The author recommends that patients entering methadone maintenance should be informed of the risks and should be required to give written consent to treatment. To prevent fatal methadone toxicity, patients should receive daily medical assessment during the first 1-2 weeks of maintenance.</description><identifier>ISSN: 0959-5236</identifier><identifier>EISSN: 1465-3362</identifier><identifier>DOI: 10.1080/09595239800187551</identifier><identifier>PMID: 16203464</identifier><language>eng</language><publisher>Oxford, UK: Informa UK Ltd</publisher><subject>Alcohol ; Attrition (Research Studies) ; Cadavers ; Committees ; Death ; deaths ; Departments ; Drug abusers ; Drug dosages ; Drug overdose ; Edema ; Factors ; Heroin ; Human remains ; Iatrogenesis ; iatrogenic ; Lungs ; Maintenance ; Methadone ; Morphine ; Mortality ; Narcotics ; Neurological Impairments ; New South Wales ; Patients ; Persuasive Discourse ; Pharmaceuticals ; Police ; Substance Abuse ; Substance abuse treatment ; Toxicity ; Toxicology ; Treatment ; Unemployment</subject><ispartof>Drug and alcohol review, 1998-03, Vol.17 (1), p.9-17</ispartof><rights>1998 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 1998</rights><rights>1998 Australasian Professional Society on Alcohol and other Drugs</rights><rights>Copyright Carfax Publishing Company Mar 1998</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5225-ae7b84e03f2e0307623bd39d433f92aed8230b3493461cfc566b48ef9db7577a3</citedby><cites>FETCH-LOGICAL-c5225-ae7b84e03f2e0307623bd39d433f92aed8230b3493461cfc566b48ef9db7577a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1080/09595239800187551$$EPDF$$P50$$Ginformahealthcare$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1080/09595239800187551$$EHTML$$P50$$Ginformahealthcare$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,31000,45574,45575,61221,61402</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16203464$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Caplehorn, John R.M.</creatorcontrib><title>Deaths in the first two weeks of maintenance treatment in NSW in 1994: Identifying cases of iatrogenic methadone toxicity</title><title>Drug and alcohol review</title><addtitle>Drug Alcohol Rev</addtitle><description>A study was undertaken to estimate the frequency of iatrogenic methadone toxicity in the first 2 weeks of maintenance treatment in NSW. Cases were identified from a list of all 1994 methadone-associated deaths using data on methadone patients held by the NSW and Queensland Health Departments. The likely causes of death were determined from data collected from coronial files. A forensic toxicologist experienced in the area gave an independent opinion. Of the 14 deaths in the first 2 weeks of maintenance, at least 10 were primarily caused by the toxic effects of methadone prescribed by NSW doctors. The rate of fatal iatrogenic methadone toxicity was 2.2 per thousand admissions to maintenance. Victims of fatal iatrogenic toxicity often displayed signs of methadone intoxication in the days before their death. They invariably died several hours after taking the fatal dose, usually after seeming to go to sleep. Often friends or family were concerned about their welfare, were unable to rouse them from their "sleep" and frequently reported the deceased was "snoring" loudly for some time before their demise. The author recommends that patients entering methadone maintenance should be informed of the risks and should be required to give written consent to treatment. To prevent fatal methadone toxicity, patients should receive daily medical assessment during the first 1-2 weeks of maintenance.</description><subject>Alcohol</subject><subject>Attrition (Research Studies)</subject><subject>Cadavers</subject><subject>Committees</subject><subject>Death</subject><subject>deaths</subject><subject>Departments</subject><subject>Drug abusers</subject><subject>Drug dosages</subject><subject>Drug overdose</subject><subject>Edema</subject><subject>Factors</subject><subject>Heroin</subject><subject>Human remains</subject><subject>Iatrogenesis</subject><subject>iatrogenic</subject><subject>Lungs</subject><subject>Maintenance</subject><subject>Methadone</subject><subject>Morphine</subject><subject>Mortality</subject><subject>Narcotics</subject><subject>Neurological Impairments</subject><subject>New South Wales</subject><subject>Patients</subject><subject>Persuasive Discourse</subject><subject>Pharmaceuticals</subject><subject>Police</subject><subject>Substance Abuse</subject><subject>Substance abuse 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in the first two weeks of maintenance treatment in NSW in 1994: Identifying cases of iatrogenic methadone toxicity</title><author>Caplehorn, John R.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5225-ae7b84e03f2e0307623bd39d433f92aed8230b3493461cfc566b48ef9db7577a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Alcohol</topic><topic>Attrition (Research Studies)</topic><topic>Cadavers</topic><topic>Committees</topic><topic>Death</topic><topic>deaths</topic><topic>Departments</topic><topic>Drug abusers</topic><topic>Drug dosages</topic><topic>Drug overdose</topic><topic>Edema</topic><topic>Factors</topic><topic>Heroin</topic><topic>Human remains</topic><topic>Iatrogenesis</topic><topic>iatrogenic</topic><topic>Lungs</topic><topic>Maintenance</topic><topic>Methadone</topic><topic>Morphine</topic><topic>Mortality</topic><topic>Narcotics</topic><topic>Neurological Impairments</topic><topic>New South Wales</topic><topic>Patients</topic><topic>Persuasive Discourse</topic><topic>Pharmaceuticals</topic><topic>Police</topic><topic>Substance Abuse</topic><topic>Substance abuse treatment</topic><topic>Toxicity</topic><topic>Toxicology</topic><topic>Treatment</topic><topic>Unemployment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Caplehorn, John R.M.</creatorcontrib><collection>Istex</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Education Database (Alumni Edition)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology 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Cases were identified from a list of all 1994 methadone-associated deaths using data on methadone patients held by the NSW and Queensland Health Departments. The likely causes of death were determined from data collected from coronial files. A forensic toxicologist experienced in the area gave an independent opinion. Of the 14 deaths in the first 2 weeks of maintenance, at least 10 were primarily caused by the toxic effects of methadone prescribed by NSW doctors. The rate of fatal iatrogenic methadone toxicity was 2.2 per thousand admissions to maintenance. Victims of fatal iatrogenic toxicity often displayed signs of methadone intoxication in the days before their death. They invariably died several hours after taking the fatal dose, usually after seeming to go to sleep. Often friends or family were concerned about their welfare, were unable to rouse them from their "sleep" and frequently reported the deceased was "snoring" loudly for some time before their demise. The author recommends that patients entering methadone maintenance should be informed of the risks and should be required to give written consent to treatment. To prevent fatal methadone toxicity, patients should receive daily medical assessment during the first 1-2 weeks of maintenance.</abstract><cop>Oxford, UK</cop><pub>Informa UK Ltd</pub><pmid>16203464</pmid><doi>10.1080/09595239800187551</doi><tpages>9</tpages></addata></record> |
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source | Access via Wiley Online Library; Applied Social Sciences Index & Abstracts (ASSIA); Taylor & Francis:Master (3349 titles) |
subjects | Alcohol Attrition (Research Studies) Cadavers Committees Death deaths Departments Drug abusers Drug dosages Drug overdose Edema Factors Heroin Human remains Iatrogenesis iatrogenic Lungs Maintenance Methadone Morphine Mortality Narcotics Neurological Impairments New South Wales Patients Persuasive Discourse Pharmaceuticals Police Substance Abuse Substance abuse treatment Toxicity Toxicology Treatment Unemployment |
title | Deaths in the first two weeks of maintenance treatment in NSW in 1994: Identifying cases of iatrogenic methadone toxicity |
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