ArticleCharacterization of Methadone Overdose: Clinical Considerations and the Scientific EvidenceWolff, KimAuthor Information National Addiction Centre, London, United Kingdom. Received December 4, 2000; accepted February 14, 2002. Address correspondence and reprint requests to Kim Wolff, National Addiction Centre, Addiction Science Building, 4 Windsor Walk, London SE5 8AF, UK; E-mail: [email protected] Therapeutic Drug Monitoring: August 2002 - Volume 24 - Issue 4 - p 457-470 Buy Abstract Overdosing with methadone is a growing phenomenon in Britain and other countries due to the increase in prescription and the availability of this compound. Little is known of the circumstances surrounding methadone death due to some extent to the difficulty of defining drug-related death and also the difficulty of collecting clinical and biographical data in a predominantly illegal and marginal milieu. However, the evidence points to highest risk at night (to this end manifestations of its toxicity often go unrecognized) in those whose usual tolerance has been reduced and occurring some considerable time after ingestion. Further investigations are needed to elucidate fully the mechanism and spectrum of methadone overdose. Death from methadone is eminently preventable more so because of the long-term nature of the clinical sequelae. Indeed the key issue with methadone that sets it apart from other opioids is its potential for delayed toxicity. Consequently steps should be taken to disseminate the salient facts to all those who come into contact with the drug. © 2002 Lippincott Williams & Wilkins, Inc.