Methadone Toxicity in Infants: a Report of Two Fatalities

Overview

Journal Forensic Sci Med Pathol

Specialties Forensic Sciences
Pathology

Date 2010 Jan 21

PMID 20087792

Citations 1

Authors

V Mistry

A J Jeffery

W Madira

C J H Padfield

G N Rutty

Affiliations

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Abstract

Fatalities in infants resulting from methadone toxicity are rare within the United Kingdom. We report two cases of fatality attributed to methadone toxicity in infants aged 3(1/2) and 15 months of age, respectively. One of the two cases was also associated with diazepam ingestion. We discuss the difficulties with the interpretation of paediatric forensic toxicology and review the current literature related to methadone and diazepam toxicity in infants and older children.

Citing Articles

The Role of Risk or Contributory Death Factors in Methadone-Related Fatalities: A Review and Pooled Analysis.

Giorgetti A, Pascali J, Montisci M, Amico I, Bonvicini B, Fais P Metabolites. 2021; 11(3).

PMID: 33810163 PMC: 8004630. DOI: 10.3390/metabo11030189.

References

NAEVE W, KORNER K . [Overdose of methadon causing death in infant]. Arch Toxikol. 1954; 15(2):96-9. View

Cook D, Braithwaite R, Hale K . Estimating antemortem drug concentrations from postmortem blood samples: the influence of postmortem redistribution. J Clin Pathol. 2000; 53(4):282-5. PMC: 1731178. DOI: 10.1136/jcp.53.4.282. View

Harkin K, Quinn C, Bradley F . Storing methadone in babies' bottles puts young children at risk. BMJ. 1999; 318(7179):329-30. PMC: 1114793. View

Sachdeva D, Stadnyk J . Are one or two dangerous? Opioid exposure in toddlers. J Emerg Med. 2005; 29(1):77-84. DOI: 10.1016/j.jemermed.2004.12.015. View

Garcia-Bournissen F, Rokach B, Karaskov T, Gareri J, Koren G . Detection of stimulant drugs of abuse in maternal and neonatal hair. Forensic Sci Med Pathol. 2015; 3(2):115-8. DOI: 10.1007/s12024-007-0007-4. View

ARONOW R, Paul S, Woolley P . Childhood poisoning. An unfortunate consequence of methadone availability. JAMA. 1972; 219(3):321-4. DOI: 10.1001/jama.219.3.321. View

Shakleya D, Jansson L, Huestis M . Validation of a LC-APCI-MS/MS method for quantification of methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) and 2-ethyl-5-methyl-3,3-diphenylpyraline (EMDP) in infant plasma following protein precipitation. J Chromatogr B Analyt Technol Biomed Life Sci. 2007; 856(1-2):267-72. DOI: 10.1016/j.jchromb.2007.06.004. View

Kintz P, Villain M, Dumestre-Toulet V, Capolaghi B, Cirimele V . Methadone as a chemical weapon: two fatal cases involving babies. Ther Drug Monit. 2006; 27(6):741-3. DOI: 10.1097/01.ftd.0000179850.50019.7d. View

Couper F, Chopra K, Pierre-Louis M . Fatal methadone intoxication in an infant. Forensic Sci Int. 2005; 153(1):71-3. DOI: 10.1016/j.forsciint.2005.04.014. View

10.

DiMaio D, DiMaio T . Fatal methadone poisoning in children: report of four cases. J Forensic Sci. 1973; 18(2):130-4. View

11.

Heimann G . Enteral absorption and bioavailability in children in relation to age. Eur J Clin Pharmacol. 1980; 18(1):43-50. DOI: 10.1007/BF00561477. View

12.

Kintz P . Value of hair analysis in postmortem toxicology. Forensic Sci Int. 2004; 142(2-3):127-34. DOI: 10.1016/j.forsciint.2004.02.027. View

13.

Smialek J, Monforte J, ARONOW R, SPITZ W . Methadone deaths in children. A continuing problem. JAMA. 1977; 238(23):2516-7. View

14.

Richardson T . Pitfalls in forensic toxicology. Ann Clin Biochem. 2000; 37 ( Pt 1):20-44. DOI: 10.1258/0004563001901498. View

15.

Baden M . Methadone related deaths in New York City. Int J Addict. 1970; 5(3):489-98. DOI: 10.3109/10826087009057014. View

16.

Langlois N, Ellis P, Little D, Hulewicz B . Toxicologic analysis in cases of possible sudden infant death syndrome: a worthwhile exercise?. Am J Forensic Med Pathol. 2002; 23(2):162-6. DOI: 10.1097/00000433-200206000-00010. View

17.

Meadow R . ABC of child abuse. Poisoning. BMJ. 1989; 298(6685):1445-6. PMC: 1836585. DOI: 10.1136/bmj.298.6685.1445. View

18.

Milroy C, FORREST A . Methadone deaths: a toxicological analysis. J Clin Pathol. 2000; 53(4):277-81. PMC: 1731168. DOI: 10.1136/jcp.53.4.277. View

19.

Flanagan R, Rooney C, Griffiths C . Fatal poisoning in childhood, England & Wales 1968-2000. Forensic Sci Int. 2005; 148(2-3):121-9. DOI: 10.1016/j.forsciint.2004.04.083. View

20.

Levine B, Wu S, Dixon A, Smialek J . Site dependence of postmortem blood methadone concentrations. Am J Forensic Med Pathol. 1995; 16(2):97-100. DOI: 10.1097/00000433-199506000-00002. View