Kriikku Pirkko, Hurme Hannes, Wilhelm Lars, Rintatalo Janne, Hurme Jukka, Kramer Jan, Ojanperä Ilkka
*Vita Laboratory, Vita Health Care Services Ltd, Helsinki; †Department of Forensic Medicine, Hjelt Institute, University of Helsinki; ‡Medical School, University of Eastern Finland, Kuopio; §LADR GmbH MVZ Dr. Kramer & Colleagues, Geesthacht, Germany; ¶National Bureau of Investigation Forensic Laboratory, Vantaa, Finland; and ‖Medical Department I, University of Lübeck, Germany.
Ther Drug Monit. 2015 Jun;37(3):339-46. doi: 10.1097/FTD.0000000000000138.
Sedative-hypnotics are commonly encountered in drivers apprehended for driving under the influence of drugs (DUID). Previous research has mainly concentrated on the residual effects of the drugs.
In this study, the extent of sleep medication use and abuse among drivers apprehended on suspicion of DUID was assessed. Additionally, the prevalence and concentrations of the drugs, concomitant use of other drugs of abuse, and the age and sex of the drivers positive for the most commonly prescribed sedative-hypnotics (temazepam, midazolam, nitrazepam, zopiclone, and zolpidem) in DUID cases in Finland in 2009 to 2011 were examined.
Sedative-hypnotics were found in 3155 samples of the 13,248 that were analyzed. Temazepam was present in over half of the cases (57.9%), along with other benzodiazepines such as midazolam (13.1%) and nitrazepam (7.0%) and the non-benzodiazepine hypnotics zopiclone (12.2%) and zolpidem (9.8%). The mean age of the drivers using the studied sedative-hypnotics was 33.5 years. Many of the drivers were polydrug users; concomitant stimulant use was found in nearly half of the cases. Cannabis and alcohol were also very common co-findings. In nearly 20% of the cases, the driver had taken more than 1 of the studied sedative-hypnotics; only 2.5% had no findings other than a single sedative-hypnotic in their blood. The drug use pattern of those positive for zopiclone and zolpidem was somewhat different from that of users of benzodiazepine sedative-hypnotics; their age was higher and the concomitant use of illegal stimulants was markedly less prevalent than among the users of temazepam, midazolam, and nitrazepam.
There were very few cases in our study population where the positive sedative-hypnotic finding could have been due to appropriate medical use. The extremely prevalent concomitant use of other psychoactive drugs and the high median serum concentrations of the studied sedative-hypnotics suggest their widespread abuse among apprehended drivers.
在因药物影响而被逮捕的司机中，镇静催眠药很常见。以往的研究主要集中在药物的残留效应上。
在本研究中，评估了因涉嫌药物影响驾驶而被逮捕的司机中睡眠药物的使用和滥用程度。此外，还调查了2009年至2011年芬兰药物影响驾驶案件中最常用的镇静催眠药（替马西泮、咪达唑仑、硝西泮、佐匹克隆和唑吡坦）的药物流行率和浓度、其他滥用药物的合并使用情况以及阳性司机的年龄和性别。
在分析的13248个样本中，有3155个样本检测出镇静催眠药。超过一半的病例（57.9%）中存在替马西泮，还有其他苯二氮䓬类药物，如咪达唑仑（13.1%）和硝西泮（7.0%），以及非苯二氮䓬类催眠药佐匹克隆（12.2%）和唑吡坦（9.8%）。使用所研究的镇静催眠药的司机的平均年龄为33.5岁。许多司机是多药使用者；近一半的病例中发现同时使用兴奋剂。大麻和酒精也是非常常见的共同发现。在近20%的病例中，司机服用了不止一种所研究的镇静催眠药；只有2.5%在血液中除了单一的镇静催眠药外没有其他发现。佐匹克隆和唑吡坦阳性者的用药模式与苯二氮䓬类镇静催眠药使用者有所不同；他们的年龄较大，非法兴奋剂的合并使用率明显低于替马西泮、咪达唑仑和硝西泮使用者。
在我们的研究人群中，很少有阳性镇静催眠药检测结果可能是由于适当医疗使用的情况。其他精神活性药物的极其普遍的合并使用以及所研究的镇静催眠药的高血清中位数浓度表明它们在被捕司机中广泛滥用。
