Forensic Investigation of Methadone Concentrations in Deceased Breastfed Infants

Forensic Summary by Gina Gallucci

Methadone is a drug prescribed to lessen the withdrawal symptoms in those addicted to heroin and other narcotics. It is often prescribed during pregnancy into the postmortem period. However, it is largely unknown if methadone levels in deceased infants who were breastfeeding are toxicologically significant. In two presented cases, alcohol, medications, and other drugs of abuse were ruled out, and testing was performed on genes related to methadone response and metabolism.

In both infants, postmortem blood levels of methadone were higher than that in living infants whose mothers were prescribed methadone while breastfeeding. Postmortem redistribution of methadone was indicated. Gene testing found that both infants were heterozygous for SNPs that are shown to increase the amount of methadone that crosses the blood-brain barrier. However, cause of death was unascertained in both cases.

Madadi, Parvaz, Lauren E. Kelly, Colin J. Ross, Charis Kepron, James N. Edwards, and Gideon Koren. “Forensic Investigation of Methadone Concentrations in Deceased Breastfed Infants.” Journal of Forensic Sciences 61.2 (2015): 576-80. Web.

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