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Corliss, Robert F. MD*; Mandal, Rakesh MBBS, MS, MPH†; Soriano, Benjamin J. MD*
Abstract: Methadone continues to be a widely used maintenance therapy for opiate dependence. However, methadone-related deaths have been reported frequently for over 4 decades now. Anoxic brain injury with pulmonary edema secondary to respiratory depression is the recognized mechanism of methadone death, although pathological intracranial findings are rarely described in methadone deaths. A selective area of brain injury has never been reported with methadone use. We present a case of a 23-year-old man who had acute necrosis of the bilateral globi pallidi in the brain and systemic rhabdomyolysis after ingesting methadone and nasally insufflating alprazolam. We also present a review of the literature on deaths following opioid use and associated brain injury.
© 2013 Lippincott Williams & Wilkins, Inc.
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methadone toxicity, benzodiazepine toxicity, globus pallidus injury, rhabdomyolysis, opioid death
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