From the Kaiser Permanente (MJW), Union City, CA; Department of Behavioral Sciences (PAN, SLW), Center on Drug and Alcohol Research, University of Kentucky, Lexington; AIT Laboratories (GB), Indianapolis, IN; and North Dakota State Forensic Examiner (WM), Bismarck.
J Addict Med. 2013 Jul-Aug;7(4):223-9. doi: 10.1097/ADM.0b013e31828c4d33.
Nonmedical use of prescription drugs and poisoning overdose deaths related to prescription drugs are increasing. This article presents an in-depth description of decedents from rural southwestern Virginia, where methadone was identified on toxicology.
Cases for this study were derived from a population-based review of 893 drug-related deaths occurring from 1997 to 2003 in the Office of the Medical Examiner, Western District of Virginia.
Deaths in which methadone was identified on toxicology in rural southwestern Virginia increased rapidly over the 7-year study period. In the majority of cases, the cause of death was polydrug toxicity, and the manner of death was classified as accident. A majority of decedents did not have prescriptions for drugs identified on toxicology. The mean concentration of methadone for all cases was 495 mg/L, and there was no significant difference between concentrations where methadone was found alone or in combination with other drugs. There was a significant difference in methadone concentrations for those with prescriptions (645 mg/L vs 449 mg/L) when compared with those without.
Cases where methadone was identified on toxicology increased significantly over the time studied. Efforts to prevent these deaths include the use of State Prescription Monitoring Programs, Universal Precautions, and Guidelines from the Federation of State Medical Boards.
处方药物的非医疗使用和与处方药物相关的中毒过量死亡正在增加。本文深入描述了弗吉尼亚州西南部农村地区的死者情况，在那里毒理学检测到了美沙酮。
本研究的病例源自于 1997 年至 2003 年期间弗吉尼亚州西部法医办公室对 893 例与药物相关的死亡进行的基于人群的审查。
在弗吉尼亚州西南部农村地区，毒理学检测到美沙酮的死亡案例在 7 年的研究期间迅速增加。在大多数情况下，死因是多药毒性，死亡方式被归类为意外。大多数死者没有处方药物，这些药物在毒理学上被发现。所有案例中美沙酮的平均浓度为 495mg/L，且当美沙酮单独或与其他药物混合存在时，浓度没有显著差异。与有处方的人相比（645mg/L 比 449mg/L），没有处方的人的美沙酮浓度有显著差异。
在研究期间，毒理学检测到美沙酮的案例显著增加。预防这些死亡的措施包括使用州处方监测计划、普遍预防措施和州医学委员会联合会的指南。
