SUDDEN DEATH MISDIAGNOSED AS METHADONE OVERDOSE: HAZARDS OF CRIMINALIZATION OF MEDICINE

*Alen J. Salerian MD

ABSTRACT

I report the case history of a 25 year old man with schizoaffective disorder, substance addiction and recent history of self-inflicted burn injuries who died while asleep a week after he began taking methadone for pain and mood stabilization. Human errors and administrative flaws let an initial wrongful diagnosis of methadone overdose remain as the official cause of death despite the overwhelming evidence that the most likely cause of death was congenital cardiac hypertrophic myopathy and not caused by methadone overdose. This case illustrates how human errors may lead to wrongful diagnosis and a wrongful revocation of medical licensure. It also illustrates the profound adverse consequences of criminalization of medicine for people with chronic pain, addiction and psychiatric disorders as eight patients died, seven of them by suicide within one year of interrupted opiate treatment.

Keywords: Methadone; opiates; congenital cardiac hypertrophic myopathy; criminalization of medicine.