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Two cases are reported in which methadone was detected in deceased neonates whose mothers were enrolled in methadone maintenance programs and were breastfeeding. In addition to a complete autopsy and toxicological testing for alcohol, prescription medications, and drugs of abuse, pharmacogenetic analysis was performed for variants in genes related to methadone metabolism and response. In both cases, the postmortem methadone concentration measured in neonatal heart blood was higher than the maximum serum methadone concentration reported in living breastfed infants whose mothers were receiving methadone. However, additional analysis of antemortem blood indicated postmortem redistribution of methadone. Pharmacogenetic results were suggestive of a potential predisposition to methadone toxicity based on studies in adults; the significance of these findings in breastfed neonates requires further research. The medical cause of death was unascertained in both cases.<\/jats:p>","DOI":"10.1111\/1556-4029.12972","type":"journal-article","created":{"date-parts":[[2015,10,29]],"date-time":"2015-10-29T16:30:09Z","timestamp":1446136209000},"page":"576-580","source":"Crossref","is-referenced-by-count":13,"title":["Forensic Investigation of Methadone Concentrations in Deceased Breastfed Infants"],"prefix":"10.1111","volume":"61","author":[{"given":"Parvaz","family":"Madadi","sequence":"first","affiliation":[{"name":"Toxicology Section Centre of Forensic Sciences Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren E.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology Schulich School of Medicine and Dentistry, and Ivey Chair in Molecular Toxicology Western University London ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin J.","family":"Ross","sequence":"additional","affiliation":[{"name":"Centre for Molecular Medicine and Therapeutics University of British Columbia Vancouver BC Canada"},{"name":"Child and Family Research Institute University of British Columbia Vancouver BC Canada"},{"name":"Division of Translational Therapeutics Department of Pediatrics University of British Columbia Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charis","family":"Kepron","sequence":"additional","affiliation":[{"name":"Ontario Forensic Pathology Service Ottawa ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James N.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Office of the Chief Coroner of Ontario Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gideon","family":"Koren","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology Schulich School of Medicine and Dentistry, and Ivey Chair in Molecular Toxicology Western University London ON Canada"},{"name":"Division of Clinical Pharmacology and Toxicology Department of Pediatrics Hospital for Sick Children Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,10,29]]},"reference":[{"key":"e_1_2_3_2_1","unstructured":"Office of the Chief Coroner of Ontario.Paediatric Death Review Committee and Deaths Under Five Committee annual report 2013;http:\/\/www.mcscs.jus.gov.on.ca\/stellent\/groups\/public\/@mcscs\/@www\/@com\/documents\/webasset\/ec163306.pdf(accessed September 5 2014)."},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)34855-1"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/089033449701300312"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2125.1997.t01-1-00624.x"},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/089033440001600206"},{"key":"e_1_2_3_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0306-5251.2001.01506.x"},{"key":"e_1_2_3_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334407300336"},{"key":"e_1_2_3_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-1182"},{"key":"e_1_2_3_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2007.0032"},{"key":"e_1_2_3_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2010.0060"},{"key":"e_1_2_3_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-1561"},{"key":"e_1_2_3_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2010.66"},{"key":"e_1_2_3_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2011.280"},{"key":"e_1_2_3_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2010.127"},{"key":"e_1_2_3_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/anatox\/35.7.431"},{"key":"e_1_2_3_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/FPC.0b013e32835cb2e2"},{"key":"e_1_2_3_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369-1600.2011.00349.x"},{"key":"e_1_2_3_19_1","doi-asserted-by":"publisher","DOI":"10.1067\/mcp.2001.117412"},{"key":"e_1_2_3_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-003-1718-1"},{"key":"e_1_2_3_21_1","doi-asserted-by":"publisher","DOI":"10.1124\/dmd.31.6.742"},{"key":"e_1_2_3_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.clpt.6100120"},{"key":"e_1_2_3_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1987.47"},{"key":"e_1_2_3_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000433-199506000-00002"},{"issue":"23","key":"e_1_2_3_25_1","doi-asserted-by":"crossref","first-page":"2516","DOI":"10.1001\/jama.1977.03280240062022","article-title":"Methadone deaths in children. 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