The Electrocardiographic Conundrum in a Patient on Methadone Maintenance Therapy and Cannabis Coingestion: A Case Report of a Heartbreaking Puzzle

Methadone is considered relatively safe when compared to other opioids. Methadone, however, can cause respiratory depression and QT prolongation. Among patients on methadone maintenance therapy, the rate of cannabis use is high. Multiple hypotheses, including the ‘exit hypothesis’ or ‘the cannabis a...

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Main Authors: Muhammad Adnan Zaman, Amna Amir, Lou Mastrine
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-10-01
Series:Heart Views
Subjects:
Online Access:https://journals.lww.com/10.4103/heartviews.heartviews_124_24
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author Muhammad Adnan Zaman
Amna Amir
Lou Mastrine
author_facet Muhammad Adnan Zaman
Amna Amir
Lou Mastrine
author_sort Muhammad Adnan Zaman
collection DOAJ
description Methadone is considered relatively safe when compared to other opioids. Methadone, however, can cause respiratory depression and QT prolongation. Among patients on methadone maintenance therapy, the rate of cannabis use is high. Multiple hypotheses, including the ‘exit hypothesis’ or ‘the cannabis association with reduced opioid use,’ need validation and further research. In this article, we present an interesting case of a 29-year-old female on methadone maintenance therapy for fifteen years who presented with methadone toxicity likely induced by systemic infection and cannabis co-ingestion. The patient had multiple cardiotoxic effects, including prolonged QT interval managed by antiarrhythmic medications, ST-segment elevation, and stress-induced cardiomyopathy managed conservatively. In this case report, the authors want to highlight the possible effects of methadone and cannabis co-injection, methadone toxicity induced by systemic infections, and increased awareness of these potentially catastrophic cardiotoxic effects in patients on high-dose methadone maintenance therapy.
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publisher Wolters Kluwer Medknow Publications
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spelling doaj-art-85a09c1c29ea4d65b76535afc8cd1a3f2025-08-20T02:32:00ZengWolters Kluwer Medknow PublicationsHeart Views1995-705X0976-51232024-10-0125427527910.4103/heartviews.heartviews_124_24The Electrocardiographic Conundrum in a Patient on Methadone Maintenance Therapy and Cannabis Coingestion: A Case Report of a Heartbreaking PuzzleMuhammad Adnan ZamanAmna AmirLou MastrineMethadone is considered relatively safe when compared to other opioids. Methadone, however, can cause respiratory depression and QT prolongation. Among patients on methadone maintenance therapy, the rate of cannabis use is high. Multiple hypotheses, including the ‘exit hypothesis’ or ‘the cannabis association with reduced opioid use,’ need validation and further research. In this article, we present an interesting case of a 29-year-old female on methadone maintenance therapy for fifteen years who presented with methadone toxicity likely induced by systemic infection and cannabis co-ingestion. The patient had multiple cardiotoxic effects, including prolonged QT interval managed by antiarrhythmic medications, ST-segment elevation, and stress-induced cardiomyopathy managed conservatively. In this case report, the authors want to highlight the possible effects of methadone and cannabis co-injection, methadone toxicity induced by systemic infections, and increased awareness of these potentially catastrophic cardiotoxic effects in patients on high-dose methadone maintenance therapy.https://journals.lww.com/10.4103/heartviews.heartviews_124_24cannabiscardiotoxicitymethadone maintenance therapymethadone toxicityqt interval prolongationst-segment elevation
spellingShingle Muhammad Adnan Zaman
Amna Amir
Lou Mastrine
The Electrocardiographic Conundrum in a Patient on Methadone Maintenance Therapy and Cannabis Coingestion: A Case Report of a Heartbreaking Puzzle
Heart Views
cannabis
cardiotoxicity
methadone maintenance therapy
methadone toxicity
qt interval prolongation
st-segment elevation
title The Electrocardiographic Conundrum in a Patient on Methadone Maintenance Therapy and Cannabis Coingestion: A Case Report of a Heartbreaking Puzzle
title_full The Electrocardiographic Conundrum in a Patient on Methadone Maintenance Therapy and Cannabis Coingestion: A Case Report of a Heartbreaking Puzzle
title_fullStr The Electrocardiographic Conundrum in a Patient on Methadone Maintenance Therapy and Cannabis Coingestion: A Case Report of a Heartbreaking Puzzle
title_full_unstemmed The Electrocardiographic Conundrum in a Patient on Methadone Maintenance Therapy and Cannabis Coingestion: A Case Report of a Heartbreaking Puzzle
title_short The Electrocardiographic Conundrum in a Patient on Methadone Maintenance Therapy and Cannabis Coingestion: A Case Report of a Heartbreaking Puzzle
title_sort electrocardiographic conundrum in a patient on methadone maintenance therapy and cannabis coingestion a case report of a heartbreaking puzzle
topic cannabis
cardiotoxicity
methadone maintenance therapy
methadone toxicity
qt interval prolongation
st-segment elevation
url https://journals.lww.com/10.4103/heartviews.heartviews_124_24
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