Characteristics of fatal methadone overdose in Manchester, 1985-94

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Abstract
We examined the records of the coroner for the City of Manchester (population around 400 000) from January 1985 to December 1994 and identified all fatal overdoses. Of 602 deaths associated with drug and alcohol toxicity, 90 were attributed wholly or partly to methadone. Another person died after developing gangrene of the arm from intravenous methadone injection. In 52 of the 90 cases methadone was the sole cause of death, the remaining deaths being caused by methadone combined with other drugs or alcohol, or both. Victims' ages ranged from 2 to 50 years (mean 26.3 years; interquartile range 22 to 31 years); 79 were male. Eighteen of the victims were resident outside the city but died within its boundaries; the remainder had Manchester addresses, including one who died in Amsterdam but whose body was returned to Manchester for necropsy. Verdicts at inquest were misadventure (57), open (21), suicide (6), and accidental (1). Five inquests (on four children, aged 2 or 3 years, and one adult) were adjourned for criminal proceedings. Charges were brought in four, manslaughter being proved in two. In the remaining case the inquest was reopened and a verdict of unlawful killing recorded.

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