Abstract
BackgroundMethadone is well known for its long duration of action and propensity for mortality after an overdose. The present research was aimed at evaluating the clinical manifestations and time trends of methadone exposure in patients in US hospitals.MethodsWe queried the American College of Medical Toxicology’s Toxicology Investigators Consortium case registry for all cases of methadone exposure between January 1, 2010, and December 31, 2017. The collected information included demographic features, clinical presentations, therapeutic interventions, poisoning type (acute, chronic, or acute on chronic), and the reason(s) for exposure. Descriptive data and relative frequencies were used to investigate the participants’ characteristics.Our data analysis was performed using SPSS version 19 and Prism software. The trends and clinical manifestations of methadone poisoning over the time period of the study were specifically investigated.ResultsNine hundred and seventy-three patients who met our inclusion criteria, with a mean age of 41.9 ± 16.6 years (range: 11 months-78 years) were analyzed. Five hundred eighty-two (60.2%) were male. The highest rate of methadone poisoning was observed in 2013. There was an increasing rate of methadone exposures in 2010–2013, followed by a decline in 2014–2017. The most common clinical manifestations in methadone-poisoned patients were coma (48.6%) and respiratory depression (33.6%). The in-hospital mortality rate of methadone poisoning was 1.4%.ConclusionToxIC Registry data showed that inpatient methadone exposures enhanced from 2010 to 2013, after which a reduction occurred in the years 2014 to 2017.
Highlights
Methadone is well known for its long duration of action and propensity for mortality after an overdose
We queried the Toxicology Investigators Consortium (ToxIC) Case Registry for all cases of methadone poisoning recorded between Jan 1, 2010, and December 31, 2017
Using the Chi-square test, we investigated the frequency distribution of clinical manifestations in single- and coexposure cases
Summary
Methadone is well known for its long duration of action and propensity for mortality after an overdose. Methadone was developed in Germany in 1937 and introduced to the United States (US) in 1947 [1]. It is a prescription opioid and is currently one of the primary options for the medication-assisted therapy of opioid use disorder [2] and for alleviating chronic pain. It has a high abuse potential [3]. In 2011, in the US alone, approximately 180,000 patients were reported to be on methadone maintenance therapy [6]. Another survey in the US reported that the number of individuals receiving methadone increased from about 227,000 in 2003 to over 350,000 in 2015 [7]
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