USE OF N-ALLYLNORMORPHINE IN TREATMENT OF METHADONE POISONING IN MAN

Abstract

The treatment of acute narcotic poisoning (from morphine and related compounds and meperidine and methadone) has heretofore been largely symptomatic and supportive, since the analeptic drugs available were not specific antidotes for morphine. In 1943, Unna¹reported that N-allylnormorphine, a morphine derivative in which the methyl group had been replaced by an allyl group, antagonized most of the actions of morphine in experimental animals. Unna's results were confirmed by Hart and McCawley.²Later, Huggins, Glass, and Bryan,³and Smith, Lehman, and Gilfillan⁴observed that N-allylnormorphine protected dogs against the respiratory depression induced by methadone, a synthetic analgesic with morphine-like action that does not resemble morphine in chemical structure. Since there has been only one report^4aof the use of this specific antidote in the treatment of narcotic poisoning in man, it was thought desirable to record two cases of acute methadone poisoning in which N-allylnormorphine