Unintentional methadone-related overdose death in New Mexico (USA) and implications for surveillance, 1998–2002


Nina Shah
Epidemiology and Response Division
New Mexico Department of Health
1190 St Francis Drive
PO Box 26110
Santa Fe
NM 87502–6110
Tel: 505 476 3607
Fax: 505 827 0013
E-mail: nina.shah@doh.state.nm.us


Aims  To determine death rates from methadone over time, to characterize methadone-related death and to discuss public health surveillance of methadone-related death.

Design  We analyzed medical examiner data for all unintentional drug overdose deaths in New Mexico, USA, between 1998 and 2002.

Measurements  Age-adjusted death rates for methadone-related death, logistic regression models for likelihood of methadone-related death among all unintentional drug overdose deaths and bivariate comparisons within methadone-related death.

Findings  Of 1120 drug overdose deaths during this period, there were 143 (12.8%) methadone-related deaths; the death rate decreased over the time period, averaging 1.6 per 100 000. Of 143 methadone-related deaths, 22.4% were due to methadone alone, 23.8% were due to methadone/prescription drugs (no illicit drugs), 50.3% were due to methadone/illicit drugs and 3.5% were due to methadone/alcohol. These groups were significantly different in demographics, health history and circumstances of death. Of 79 decedents (55.2%) with a known source of methadone, 68 obtained methadone through a physician prescription (31 for methadone maintenance treatment (MMT), 27 for managing pain and 10 had unknown reason for prescription).

Conclusions  Methadone-related death rates and the proportion of methadone-related death among all drug overdose deaths decreased in New Mexico from 1998 to 2002. It is important for surveillance of methadone-related death to assess multiple drug causes, not just underlying cause. Also, methadone for pain management must be examined alongside MMT and when possible, methadone co-intoxication should be described in the context of other drugs causing death.