The Emergency Services Advisory Committee (ESAC) wishes to make all physicians who practise emergency medicine in British Columbia aware of recommendations from a recent (13 May 2014 [revised 30 June 2014]) BC Coroners Service Preventable Death Bulletin:*

Follow the BC Drug and Poison Information Centre (DPIC) protocol for the treatment of a methadone overdose:
•    Asymptomatic patients with suspected [methadone] overdose and children ingesting any amount should be monitored for at least 10 hours. 
•    Symptomatic patients should be monitored until all symptoms resolve; observe for resedation for at least 6 hours and, concludes the Coroner,* up to 10 hours after the last dose of naloxone.
•    Call the DPIC when a patient with poison and overdose presents at the ED (24 hours: 604 682-5050 or 1 800 567-8911).

*The full bulletin, including the DPIC protocol for the treatment of a methadone overdose, is posted on the Section of Emergency Medicine website (www.sem-bc.com [13]), the UBC Department of Emergency Medicine website (www.emergency.med.ubc.ca), and the BCMJ website (click here for the full bulletin [14]).
—Jim Christenson, MD
Head, UBC Department of Emergency Medicine
—David A. Haughton, MD
Chair, Doctors of BC Section of Emergency Medicine
—Roy Purssell, MD
Director of BC Poison Control