Deaths in the Lesbian, Gay, Bisexual and Transgender United Kingdom Communities Associated with GHB and Precursors
Deaths in the Lesbian, Gay, Bisexual and Transgender United Kingdom Communities Associated with GHB and Precursors
复制标题
DOI：
10.2174/1389200218666171108163817
复制
发表时间：
2018-01-01
影响因子：
2.3
通讯作者：
Schifano, Fabrizio
中科院分区：
文献类型：
--
作者：
Corkery, John M.;Loi, Barbara;Schifano, Fabrizio
背景：自20世纪90年代初以来，滥用γ -羟基丁酸酯（GHB）及其前药γ -丁基内酯（GBL）和1,4丁二醇（1,4- bd）的情况急剧增加，特别是在女同性恋、男同性恋、双性恋和变性（LGBT）人群中，例如在娱乐和性环境中。“chemsex”。目的和方法：本文概述了GHB药物毒理学，并提供了与使用这些物质有关的LGBT人群案例分析，这些物质摘自英国国家药物滥用死亡方案数据库，向该数据库通报是自愿的。结果：1995年至2013年9月，共报告21例GHB/ gbl相关死亡病例。没有涉及1,4- bd。典型的受害者有：男性（100%）；白人（67%），年轻（平均年龄34岁）；使用(90%);有药物滥用史（81%）。大多数死亡是意外（67%）或与娱乐性毒品使用（19%）有关，其余的（潜在的）自杀。大多数死亡（83%）发生在私人住宅，通常是在娱乐使用之后；另一些则发生在特定的“同性恋”场所，包括俱乐部和桑拿房。伦敦的三个行政区占所有通报死亡人数的62%，反映了居民和来访的“同性恋”个人的集中。然而，这可能是特定领域数据提交程序的自愿性质造成的。仅GHB/GBL就与10%的死亡有关。在其余案件中，下列物质单独或联合使用（百分比可能增加到100%以上）：可卡因（38%）；酒精(33%);安非他命(29%);迷幻药(29%);安定(24%);氯胺酮(24%);mephedrone(24%)。死后血药浓度：平均660毫克/升（范围22 - 2335；sd值726）。结论：在摄入GHB/GBL时需要非常谨慎，特别是酒精、苯二氮卓类药物、兴奋剂和氯胺酮。由于其抑制中枢神经系统的特性，死亡风险增加。其中，可卡因、甲氧麻黄酮和氯胺酮等“化学性”药物值得注意。“同性恋”群体需要更多地意识到与消费此类物质相关的风险。
Background: Misuse of gammahydroxybutrate (GHB) and its prodrugs gammabutyrolactone (GBL) and 1,4 butanediol (1,4-BD) has increased greatly since the early 1990s, particularly amongst lesbian, gay, bisexual and transgender (LGBT) individuals in recreational and sexual settings, e.g. 'chemsex'.Objective and Method: This paper presents an overview of GHB pharmacotoxicology and provides analyses of cases in the LGBT population associated with the use of these substances extracted from the UK's National Programme on Substance Abuse Deaths database, to which notification is voluntary.Results: From 1995 to September 2013, 21 GHB/GBL-associated fatalities were reported. None involved 1,4-BD. Typical victims were: Male (100%); White (67%), young (mean age 34 years); employed (90%); with a drug misuse history (81%). Most deaths were accidental (67%) or related to recreational drug use (19%), the remaining (potential) suicides. The majority of fatalities (83%) occurred in private residences, typically following recreational use; others occurred in specific 'gay'-oriented locales including clubs and saunas. Three London boroughs accounted for 62% of all notified deaths, reflecting the concentration of both resident and visiting 'gay' individuals. However, this may be an artefact of the voluntary nature of the data submission procedure in particular areas. GHB/GBL alone was implicated in 10% of fatalities. The following substances were implicated either alone or in combination in the remaining cases (percentages may add to more than 100%): cocaine (38%); alcohol (33%); amphetamines (29%); ecstasy (29%); diazepam (24%); ketamine (24%); mephedrone (24%). Post-mortem blood levels: mean 660 (range 22 - 2335; S.D. 726) mg/L.Conclusion: Significant caution is needed when ingesting GHB/GBL, particularly with alcohol, benzodiazepines, stimulants, and ketamine. Risk of death is increased due to their CNS-depressant properties. Of these, 'chemsex' drugs such as cocaine, mephedrone and ketamine are of note. More awareness is needed in the 'gay' community about risks associated with the consumption of such substances.