Like aspirin and other drugs, methadone should not be left lying around within reach of small children. The usual maintenance dose, if taken by a child, may be fatal unless proper treatment is instituted. Some methadone maintenance programs therefore require that patients who take home methadone mixed with a soft drink must carry and store it in a locked box. Dr. Dole has developed, and a pharmaceutical company is marketing, a methadone tablet that is not readily injectable, need not be mixed with a soft drink, and need not be refrigerated. The new tablets are now in use in many programs, and are expected to reduce the risk of methadone overdose in children.
Nalorphine produces almost immediate relief.
A few methadone overdose deaths have been reported, however, in children given only one injection of nalorphine. The antagonist works like magic-but its effect lasts only for a few hours, while the methadone effect may persist for a day or more. After the first nalorphine dose wears off, the child may again fall into a life-threatening methadone coma. Hence, the hospital staff must keep the child under continuous observation, and repeat the nalorphine injection whenever signs of lethargy occur. Footnotes Chapter 16 1.