Minett William J, Moore Tara L, Juhascik Matthew P, Nields Henry M, Hull Mindy J
Office of the Chief Medical Examiner, Commonwealth of Massachusetts, Boston, MA 02118, USA.
J Forensic Sci. 2010 Sep;55(5):1319-25. doi: 10.1111/j.1556-4029.2010.01408.x.
The relationship between postmortem concentrations of morphine and co-detected psychoactive drugs in fatal overdoses is examined. Morphine and other drugs were detected in 161 medicolegal autopsy cases. Subsets of these morphine-positive cases based on drug class were established, including opioids, antidepressants, ethanol, benzodiazepines, and "other." Each subset was split into high or low concentration groups based on median drug concentrations. Morphine concentrations of the [high] and [low] groups were compared, with no significant difference in morphine concentration identified in the opioid, ethanol, or benzodiazepine subsets. The "other" drug class was too heterogeneous for statistical assessment. Morphine concentrations did show a significant direct relationship (p = 0.01) with antidepressants, namely increased concentrations of antidepressant drugs are associated with an increased concentration of morphine. This trend probably remains even after excluding cocaine-positive cases. The unsuspected finding that postmortem concentrations of antidepressants positively correlate with morphine levels may be important in the treatment of depression in drug addicts.
研究了致命性药物过量中毒案件中吗啡的死后浓度与共同检测出的精神活性药物之间的关系。在161例法医尸检案件中检测到了吗啡和其他药物。根据药物类别，将这些吗啡阳性病例分为不同子集，包括阿片类药物、抗抑郁药、乙醇、苯二氮䓬类药物和“其他”药物。每个子集根据药物浓度中位数分为高浓度组或低浓度组。比较了[高]组和[低]组的吗啡浓度，在阿片类药物、乙醇或苯二氮䓬类药物子集中未发现吗啡浓度有显著差异。“其他”药物类别过于混杂，无法进行统计学评估。吗啡浓度确实与抗抑郁药呈显著正相关（p = 0.01），即抗抑郁药浓度升高与吗啡浓度升高相关。即使排除可卡因阳性病例，这种趋势可能仍然存在。抗抑郁药的死后浓度与吗啡水平呈正相关这一意外发现可能对药物成瘾者的抑郁症治疗具有重要意义。
