Forensic Institute, Ghent University, Belgium.
Curr Pharm Biotechnol. 2010 Aug;11(5):453-9. doi: 10.2174/138920110791591553.
In this paper, the distribution and redistribution of the amphetamine derivative, 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) is brought into focus. Animal experimental data were compared with internationally reported MDMA-related human fatalities: in general, these turned out to be parallel with each other. Due to its inherent properties (e.g. significant volume of distribution), MDMA is liable to postmortem redistribution. Indeed, very high concentrations have been found in cardiac blood and tissues located centrally in the body (blood-rich organs such as lungs and liver in particular). This confirms that post-mortem redistribution due to diffusion from higher to lower concentration can easily take place, mainly at longer post-mortem intervals and when putrefaction occurs. Therefore, we can conclude that for post-mortem quantitation of amphetamine and derivatives, and MDMA in particular, peripheral blood sampling (e.g. femoral vein) remains compulsory. However, if the latter is impossible, MDMA quantification in a few alternative matrices such as vitreous humour and iliopsoas muscle may provide additional information to come to a reliable conclusion. Furthermore, it should be stressed that--at present--it is impossible to estimate the individual susceptibility to the various possible adverse effects of MDMA, which implies that it is impossible to provide a "safe" or "therapeutic" blood MDMA level. Therefore, in current forensic practice, the post-mortem pathological and toxicological findings should form an entity in order to draw a well-grounded conclusion.
本文聚焦于安非他命衍生物 3,4-亚甲二氧基甲基安非他命（MDMA，摇头丸）的分布和再分布。将动物实验数据与国际上报道的与 MDMA 相关的人类死亡事件进行了比较：总的来说，这些结果是相互平行的。由于其固有特性（例如，分布容积大），MDMA 易于死后再分布。事实上，在心脏血液和位于身体中央的组织（特别是富含血液的器官，如肺和肝）中发现了非常高的浓度。这证实了由于从高浓度向低浓度扩散而发生的死后再分布很容易发生，主要发生在较长的死后间隔时间和发生腐败时。因此，我们可以得出结论，对于安非他命和衍生物的死后定量，特别是 MDMA，外周血采样（例如股静脉）仍然是强制性的。然而，如果后者不可能，则可以在一些替代基质（如玻璃体和髂腰肌）中定量 MDMA，以提供额外的信息来得出可靠的结论。此外，应该强调的是——目前——无法估计个体对 MDMA 各种可能不良影响的易感性，这意味着无法提供“安全”或“治疗”的血液 MDMA 水平。因此，在当前的法医实践中，死后病理和毒理学发现应该形成一个整体，以便得出有充分根据的结论。
