First Occurrence of Fatal Intoxication Involving Methiodone (IC-26) in Finland; a Medicolegal Autopsy Case Report.
Lasse Pakanen, Raimo A Ketola, Pirkko Kriikku
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Case in brief
A person receiving opioid agonist treatment died from an intoxication in which methiodone (IC-26), a non-fentanyl synthetic opioid, was identified as the primary intoxicant. Medicolegal autopsy toxicology detected methiodone at 1.5 mg/L in femoral vein blood. The report describes this as the first published fatal intoxication involving methiodone in Finland.
What made this case unusual
Methiodone, a novel synthetic opioid with limited published toxicological case data, was identified as the primary intoxicant in a fatal case involving a person undergoing opioid agonist treatment.
Diagnostic / clinical pearl
In suspected opioid intoxication, toxicological assessment may need to consider novel synthetic opioids such as methiodone, including in people receiving opioid agonist treatment.
Why it matters
The case highlights the value of monitoring for substance use during substitution therapy, including possible exposure to emerging synthetic opioids.