Background: Intravenous drug misuse, principally heroin, occurs primarily in the Greater Dublin area. Methadone maintenance treatment has been an important part of the response to opiate misuse in Dublin since 1992.

Aims: To determine the number of opiate-related deaths in Dublin City and County during 1999, to establish the number of methadone-related deaths and determine the proportion of deaths associated with methadone prescribed according to guidelines.

Methods: A retrospective review of all coroners' inquest files in Dublin City and County during 1999 was undertaken.

Results: There were 84 opiate-related deaths. Seventy-eight (92.9%) were male. Seventy-three (86.9%) had two or more drugs identified toxicologically. There were 45 methadone-related deaths, of which 15 (33.3%) were receiving methadone prescribed according to guidelines.

Conclusion: Opiate-related deaths occur primarily in males in the 25-34 year age group and are associated with a high level of polydrug use. Diverted methadone accounted for the majority of deaths involving