Drug-induced prolonged corrected QT interval in patients with methadone and opium overdose
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(2019) 14:8
RESEARCH
Open Access
Drug-induced prolonged corrected QT interval in patients with methadone and opium overdose Davood Soroosh1, Mahbubeh Neamatshahi2, Bahram Zarmehri3*, Samaneh Nakhaee4 and Omid Mehrpour4,5
Abstract Background: Iran is a country with the highest rate of opioid addiction in the world. The most commonly used opioid in Iran is opium, and methadone is in second place. The trend of drug use has changed from opium to methadone from 2006 to 2011. Presence of a large number of addicted people and methadone maintenance therapy clinics make methadone readily available in Iran. Therefore, evaluation of the epidemiological characteristic of methadone toxicity and its effects on the heart is essential. Methods: In This cross-sectional, retrospective, descriptive, analytical study all patients with methadone or opium toxicity who had been admitted to Vasei hospital, Sabzevar, Iran, during the years 2015 and 2016 were included, and their records were evaluated. Demographic data, addiction history, underlying diseases, and the outcome of admission were recorded. Then, corrected QT interval (QTc) of the first ECG of the patients after admission was evaluated. Results: The Majority of toxicities occurred in those above 30 years of age (71.4%), who lived in cities (62.8%), and were married (69.2%). A positive history of addiction was considerably higher in the opium group (72.3% versus 43. 3%). There was no significant difference regarding QTc prolongation between patients with methadone and opium toxicity (p = 0.3). Conclusion: QTc prolongation is one of the adverse effects of methadone or opium overdose. It seems that significant QTc prolongation is not uncommon among patients with opium overdose. Keywords: Corrected QT interval, Methadone, Opium, Overdose
Introduction Iran is a country with the highest rate of opioid addiction in the world [1, 2]. Eastern Iran shares a border with Afghanistan where the majority of opium in the world is produced. Iran is the major route for drug transport to Europe [3]. It is estimated that there are about 2 million drug users in Iran that 9 to16 percent of them are intravenous drug users in Iran [4, 5]. The World Health Organization (WHO) reported that Iran has opium consumption three times greater than the mean of the world. The most commonly used opioid in Iran is opium (82%). Methadone is the third most * Correspondence: [email protected] 3 Department of emergency medicine, faculty of medicine, Mashhad university of medical sciences, Mashhad, Iran Full list of author information is available at the end of the article
common used opioid with a prevalence of 16.6% of opioid use. There are around 5000 outpatient buprenorphine or methadone maintenance therapy (MMT) clinics for the sole purpose of the treatment of opioid dependency in Iran and covered about 500,000 people for treatment [6]. In a study in Tehran, the capital city of Iran, narcotics were the second common cause of death (24.75%), and opium was the most prevalent drug of use. The trend of drug us
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