ALTHOUGH HEROIN IS USUALLY CUT WITH VARIOUS SUBSTANCES (E.G., SUGAR, CAFFEINE, OR EVEN PENICILLIN OR STRYCHNINE) FOR STREET SALE, DEATHS USUALLY OCCUR FROM OVERDOSES RATHER THAN REACTIONS TO THE ADULTURATES. IN THIS CASE, A 23-YEAR-OLD WOMAN WAS FOUND DEAD AFTER INJECTING WHAT WAS OSTENSIBLY HEROIN WITH HER FIANCE. DISSECTION OF THE CORPSE SHOWED ACUTE HEMORRHAGE OF THE GLANDS IN THE LARGE INTESTINE, AS WELL AS BRAIN AND LUNG EDEMA. HISTOLOGICAL FINDINGS INCLUDED FATTY LIVER WITH CONCENTRATIONS OF INFLAMED CELLS IN THE PERIPORTAL REGION AND INTERSTITIAL HEART EDEMA WITH FINE-BEADED FAT DEPOSITS IN THE HEART MUSCLE FIBERS. CHEMICAL EXAMINATION REVEALED LOW METHADONE CONCENTRATIONS IN THE BLOOD, HIGHER CONCENTRATIONS IN THE LIVER AND KIDNEYS, AND THE GREATEST AMOUNTS IN THE LUNGS, WITH VERY SMALL QUANTITIES IN THE STOMACH. ALL SIGNS POINTED TO PULMONARY PARALYSIS FROM METHADONE POISONING. THE 100 MG DOSE TAKEN WAS CONSIDERABLY ABOVE THAT CONSIDERED LETHAL FOR UNACCUSTOMED USERS (70 TO 100 MG ORALLY OR 40 TO 50 MG I.V.). METHADONE IS ESPECIALLY LIKELY TO HAVE SEVERE EFFECTS ON HEROIN ADDICTS WHO ARE INEXPERIENCED WITH METHADONE, FOR ALTHOUGH METHADONE USERS HAVE A HIGH TOLERANCE TO HEROIN, HEROIN USERS HAVE VIRTUALLY NO TOLERANCE TO METHADONE AND ARE PARTICULARLY SUSCEPTIBLE TO ACCIDENTAL OVERDOSES. IT IS CAUTIONED THAT THE SALE OF METHADONE IN PLACE OF HEROIN HAS RESULTED IN NUMEROUS FATALITIES IN THE UNITED STATES AND APPEARS TO HAVE BECOME MORE COMMON IN WEST GERMANY AS WELL, ESPECIALLY IN THE BERLIN DRUG SCENE. --IN GERMAN. (KMD)