Methadone-related deaths and mortality rate during induction into methadone maintenance, New South Wales, 1996

The aims of this study were to describe the causes of death in cases found positive for methadone post-mortem, the proportion of cases involving methadone syrup, and of this group, the proportion not registered in methadone maintenance treatment (MMT) at time of death, and the number of deaths during induction into MMT in New South Wales in 1996. Coronial files of cases were reviewed. Data on file with the Pharmaceutical Services Branch, NSW Health Department on number of people admitted to and discharged from MMT in 1996, and details of methadone treatment for cases in MMT, were examined. Eighty-seven methadone positive cases were identified, of which 62 (71%) died of drug-related causes. Of 9835 people inducted into MMT in 1996, seven died within the first 7 days (21% of all deaths in MMT), for an overall mortality rate (MR) of 7.1 deaths per 10 000 inductions (95% CI 1.8-12.4). Fifty-one per cent (51%) of methadone syrup-related cases occurred in people not registered in MMT. This high proportion of diversion related deaths continues to be of concern. The findings reinforce to providers of MMT the necessity of careful procedures for initiation of treatment and support the need for ongoing surveillance of methadone related deaths both in and out of MMT.