PATTERN OF USE/ABUSE OF TRAMADOL AND METHADONE IN POSTMORTEM CASES REFERRED TO THE LEGAL MEDICINE CENTER IN ARDABIL, IRAN, 2017

Background and Aim : Evidence of abuse and dependence of synthetic opioids such as tramadol and methadone is emerging issue in Iran. Tramadol and methadone abuse is underestimated and have many medical and forensic consequences. Tramadol and methadone abuse has not been well studied in Ardabil (a North-west province of Iran). The aim of this study was to estimate the pattern of tramadol and methadone use/ abuse in Ardabil.Methods : This is a prospective study involved fatal cases suspected to tramadol and methadone use/abuse which referred to the forensic toxicology laboratory at the Ardabil Legal Medicine Center (ALMC) in 2017. All biological samples (urine, stomach content, bile, and liver tissue) were analyzed by thin-layer chromatography (TLC) as screening test and confirmed by gas chromatography-mass spectrometry (GC-MS). Also, the demographic data were extracted from the cases’ records.Results : During the study period, from 210 cases were sent to the laboratory of the ALMC; 95% were male. Most of them were 35-40 years. Among them, 87% were married. The major of the cases (95%) were resident in urban area. Methadone (12.8%) and tramadol(11.4%) were detected in the cases. Conclusion : In this study, methadone and tramadol use/abuse were determined as the main cause of morbidity and mortality in drug abusers in the Ardabil province. From this view, countermeasures and prevention planning especially for young people should be considered.

Keywords:

Tramadol , Methadone , Epidemiology