A survey of buprenorphine related deaths in Singapore
A survey of buprenorphine related deaths in Singapore
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DOI：
10.1016/j.forsciint.2006.03.037
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发表时间：
2006-10-16
影响因子：
2.2
通讯作者：
Lob, Danny Siaw Teck
中科院分区：
文献类型：
--
作者：
Lai, Siang Hui;Yao, Yi Ju;Lob, Danny Siaw Teck
自2002年以来，丁丙诺啡在新加坡可作为阿片类药物依赖的替代治疗。本研究调查了2003年9月至2004年12月期间新加坡丁丙诺啡相关死亡情况。目的是确定丁丙诺啡相关死亡的尸检发生率以及病例的人口统计学和毒理学特征。对所有非自然死亡、涉及已知吸毒者的死亡以及尸检未发现明显死因的死亡进行毒理学筛查。21例病例在死后血液和/或尿液样本中检测到丁丙诺啡。18人突然死亡。有两人从高处福尔斯死亡，一人上吊死亡。所有受试者均为男性。年龄范围为24-48岁。14例受试者年龄在30 - 39岁之间。平均年龄为35岁。大多数（62%）是中国人。11人（52%）是已知的药物滥用者。对于猝死，确定了两组。6例死于自然原因。血液丁丙诺啡水平范围为未检出（尿液中检出）至3.2 ng/mL（平均1.4 ng/mL）。12例直接或间接归因于混合药物中毒。血液丁丙诺啡水平范围为未检测到（在尿液中检测到）至17 ng/mL（平均3.2 ng/mL）。19例病例显示同时滥用丁丙诺啡和苯二氮卓类药物，最常发现的是地西泮，其次是硝西泮和咪达唑仑。丁丙诺啡作为替代疗法的可用性与丁丙诺啡相关死亡的增加有关。强调了丁丙诺啡和苯并二氮杂卓共同滥用的危险。(c)2006爱思唯尔爱尔兰有限公司保留所有权利。
Buprenorphine is available in Singapore as substitution treatment for opioid dependence since 2002. This study surveys buprenorphine related deaths in Singapore between September 2003 and December 2004. The aims are to establish the autopsy prevalence of buprenorphine related deaths and the demographical and toxicological profile of the cases. Toxicological screening was performed for all unnatural deaths, deaths involving known drug addicts, as well as when autopsy revealed no obvious cause of death. Twenty-one cases had buprenorphine detected in postmortem blood and/or urine samples. Eighteen were sudden deaths. There were two fatal falls from height and one death by hanging. All subjects were male. The age range was 24-48 years. Fourteen subjects were between 30 and 39 years of age. The mean age was 35 years. The majority (62%) were Chinese. Eleven (52%) were known drug abusers. For sudden deaths, two groups were identified. Six cases died from natural causes. Blood buprenorphine levels ranged from undetected (detected in urine) to 3.2 ng/mL (mean 1.4 ng/mL). Twelve cases were attributed directly and indirectly to mixed drug poisoning. Blood buprenorphine levels ranged from undetected (detected in urine) to 17 ng/mL (mean 3.2 ng/mL). Nineteen cases showed concurrent abuse of buprenorphine and benzodiazepine, diazepam being the most frequently detected, followed by nitrazepam and midazolam. The availability of buprenorphine as substitution therapy is associated with an increase in buprenorphine related deaths. The danger of co-abuse of buprenorphine and benzodiazepines is highlighted. (c) 2006 Elsevier Ireland Ltd. All rights reserved.