There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
Drug-related fatal poisonings were analysed in Hamburg from 1990 to 30th June 1999
with special attention to the role of methadone. The first methadone-related fatalities
were observed in Hamburg three years after methadone maintenance treatment (MMT) was
introduced in 1990. Meanwhile more than half of all fatal poisonings among drug addicts
are monovalent or polydrug intoxications with evidence for methadone. From January
1997 until June 1999 methadone was the predominant cause of death in about 39% of
all drug-related fatal poisonings while the proportion of mixed heroin/methadone intoxications
was about 10%. The rising problem of methadone-related fatalities goes with a decline
of monovalent heroin intoxications which decreased in the last 9 years from 60% to
11%. Sixty-five per cent of those who died of fatal methadone-related poisonings had
no history of MMT (60% of those with methadone as predominant cause of death). Since
take-home doses for up to 7 days are prescribed to the patient due to a change in
the German Narcotics Act in 1998, the diversion of methadone into illegal markets
may have been accelerated. This results in rising numbers of non-intentional methadone-related
fatalities among addicts who have never been in MMT. The prerequisites for the prescription
of take-home doses should be taken more serious. There is no doubt that MMT reduced
the mortality rate among the great majority of patients in Hamburg but supreme efforts
should be made to prevent or reduce fatal intoxications by methadone in the non-treatment
group.