Methadone Poisonings in France: A Seven-Year Experience of the French Poison Control Center Network

Methadone is an opioid agonist prescribed in France for the treatment of opioid dependency. In order to evaluate the clinical toxicity of methadone, the authors present a seven- year experience of the French Poison Control Center (FPCC) Network at the national level. This study is a retrospective analysis of methadone exposures reported to the nine FPCC between October 15th 2010 and October 15th 2017. The two pharmaceutical forms (capsule and syrup) were considered. Childhood accidental poisonings were excluded (different study). 1415 cases of methadone poisoning were included (29% female, 71% male, average age 34 +/-10). 90% of the patients had history of addiction and 69% were treated with methadone (31% were naïve patients). The two main circumstances were addictions (47% of the cases) and suicide attempts (41%). In 45% of the cases it was capsules, in 35% syrup, unknown for 20%. The ingested methadone dose was significantly higher for suicide attempts (average dose 250 mg) than for addictions (average dose 140 mg). 126 deaths were observed representing 7% of the global deadly medicine poisonings observed during the studied period at the national level for the FPCC. Comparison of the addictions versus the suicide attempts emphasizes differences: female patients were more implicated in suicide attempts with ingestion of their own treatment, mainly capsules at home with association of benzodiazepines; while addictions concerned mainly males who ingested syrup, frequently associated with other narcotics, and with a higher morbidity and mortality (4 times more deadly evolutions with addictions than with suicide attempts).

Author(s): Katharina von Fabeck, Romain Torrents, Mathieu Glaizal, Luc de Haro, Nicolas Simon

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