[Intoxication with methadone and benzodiazepines in a morbidly obese patient in the social environment of a heroin addict receiving methadone maintenance therapy].
Methadone is a well-established maintenance drug for the therapy of opioid addicts. Reduction of mortality, social stabilization and reintegration are basic goals of this therapeutic concept. In the ideal case, total opioid abstinence can be achieved. In Germany, detailed guidelines exist for methadone maintenance treatment (e. g. choice of the maintenance drug, "take home" doses) and are regularly published and updated by the National Medical Council. In the social environment of opioid addicts, misuse or accidental intoxication in non-addict family members or co-addicts may occur. We report an intoxication with methadone of the husband of a heroin-addict patient. In this morbidly obese patient, a simultaneous ingestion of benzodiazepines was suspected. This case report describes the diagnostic and therapeutical options of an opioid intoxication in a patient with severe obesity with special emphasis on the airway management strategy in an out-of-hospital situation.