Pilgrim Jennifer L, Yafistham Sabrina Putrianita, Gaya Sanjeev, Saar Eva, Drummer Olaf H
Department of Forensic Medicine, Monash University, 57-83 Kavanagh Street, Southbank, VIC, 3006, Australia,
Forensic Sci Med Pathol. 2015 Mar;11(1):3-12. doi: 10.1007/s12024-014-9624-x. Epub 2014 Nov 18.
Oxycodone is one of the most abused prescription drugs. Iatrogenic factors that lead to oxycodone-related death, such as mis-prescribing, present an opportunity for death prevention if identified early. This study investigated deaths involving oxycodone in Australia to explore potentially inappropriate prescribing and the coroner's investigation. The National Coronial Information System identified cases from 2001 to 2011 where oxycodone was detected by toxicological analysis. There were 806 oxycodone-related deaths, with a significant increase in the 11-year period, from 21 deaths in 2001, up almost sevenfold in 2011 (139 deaths). Most deaths were caused by combined drug toxicity (63.4%) or oxycodone toxicity alone (11.8%). Most individuals were male (59.1%), aged 35-44 years (26.7%), who died unintentionally (56.4%), with mental illness (52.1%) and/or a history of acute or chronic pain (46.2%). 312 cases (39%) described a legitimate prescription for oxycodone, of which most involved non-cancer related chronic pain. About three quarters of the indications were deemed appropriate. There were at least 43 different indications treated with oxycodone that were inappropriate. The majority of oxycodone-related cases involved minor to no description of the drugs involved (n = 600; 74.4%). A moderate description of oxycodone involvement was given in 162 cases (20.1%), while only 44 cases (5.5%) involved a thorough examination and recommendations from the coroners on oxycodone and other drugs involved in death. This study emphasized the need for medical practitioners to exercise caution when prescribing oxycodone and for coroners to provide more consistent and detailed information regarding drug use, in order to identify and implement preventive strategies.
羟考酮是最常被滥用的处方药之一。导致与羟考酮相关死亡的医源性因素，如处方不当，若能早期识别，便存在预防死亡的机会。本研究调查了澳大利亚涉及羟考酮的死亡案例，以探究潜在的不适当处方及验尸官的调查情况。国家验尸信息系统识别出了2001年至2011年期间经毒理学分析检测出羟考酮的案例。共有806例与羟考酮相关的死亡案例，在这11年期间显著增加，从2001年的21例死亡，到2011年增长了近7倍（139例死亡）。大多数死亡是由药物联合毒性（63.4%）或单独的羟考酮毒性（11.8%）导致的。大多数个体为男性（59.1%），年龄在35 - 44岁之间（26.7%），意外死亡（56.4%），患有精神疾病（52.1%）和/或有急性或慢性疼痛病史（46.2%）。312例（39%）描述了羟考酮的合法处方，其中大多数涉及非癌症相关的慢性疼痛。约四分之三的用药指征被认为是合适的。至少有43种用羟考酮治疗的指征是不适当的。大多数与羟考酮相关的案例对所涉药物描述很少或没有描述（n = 600；74.4%）。162例（20.1%）对羟考酮的涉入情况有适度描述，而只有44例（5.5%）涉及验尸官对羟考酮及死亡所涉其他药物的全面审查和建议。本研究强调，医生在开具羟考酮处方时需谨慎，验尸官应提供更一致且详细的药物使用信息，以便识别并实施预防策略。
