Borriello Renata, Carfora Anna, Cassandro Paola, Petrella Raffaella
Dipartimento di Medicina Sperimentale, Scuola di Medicina, Seconda Università di Napoli, Naples, Italy. E-mail:
Ann Ist Super Sanita. 2014;50(4):328-33. doi: 10.4415/ANN_14_04_06.
The study regards n. 267 drug related deaths submitted to toxicological analyses for forensic purpose, since 2008 to 2012, at the Laboratory of Forensic Toxicology of the Second University of Napoli (SUN), Italy. Among the cases studied (94% males and 6% females) the 13.1% regards foreign citizens.
For each case autopsy findings and all drugs detected were recorded. In addition other epidemiological data such as age, race, gender, place and circumstance of death were also supplied. A systematic toxicological analysis (STA) for illicit drug, other pharmaceuticals, new psychotropic substances and ethanol has been applied on the specimens collected at autopsy and all positive results were confirmed by a quantitative analysis (GC/MS or LC-MS/MS).
Toxicological results shows that simultaneous use of multiple illicit drugs was responsible of the largest mortality rate (57.7%), in both males and females. In the polydrug use the cocaine was the most detected substance. The association of heroin/cocaine was identified in the 22.5% of deaths. The finding of only one drug was correlated with an opiate drug for the 14.2% and with cocaine for the 4.5% of cases. The distribution by age and gender demonstrates an increase in deaths among males aged over 30 years and among women older than 35 years. The territorial distribution of the deaths in the different surrounding areas and in the residential quarters of the Naples city demonstrates that the 76% of deaths occurred in a place different from the usual residence.
Results obtained demonstrate that prevails, at present, the need to specifically explore the changing patterns of polydrug use among addicts, because studying the prevalence of mortality subsequent to the consumption of a single illicit drug may be insufficient to guide preventive policies in public health.
本研究涉及2008年至2012年期间提交给意大利那不勒斯第二大学（SUN）法医毒理学实验室进行法医毒理学分析的267例药物相关死亡案例。在所研究的案例中（94%为男性，6%为女性），13.1%涉及外国公民。
记录每个案例的尸检结果和检测到的所有药物。此外，还提供了其他流行病学数据，如年龄、种族、性别、死亡地点和情况。对尸检采集的标本进行了针对非法药物、其他药品、新型精神活性物质和乙醇的系统毒理学分析（STA），所有阳性结果均通过定量分析（气相色谱/质谱或液相色谱/串联质谱）进行确认。
毒理学结果显示，男性和女性中同时使用多种非法药物导致的死亡率最高（57.7%）。在多药使用中，可卡因是检测到最多的物质。22.5%的死亡案例中发现了海洛因/可卡因的组合。仅发现一种药物的案例中，14.2%与阿片类药物相关，4.5%与可卡因相关。按年龄和性别分布显示，30岁以上男性和35岁以上女性的死亡人数有所增加。那不勒斯市不同周边地区和居民区死亡案例的地域分布表明，76%的死亡发生在与通常居住地不同的地方。
获得的结果表明，目前迫切需要专门探索吸毒者中多药使用模式的变化，因为研究单一非法药物消费后的死亡率可能不足以指导公共卫生预防政策。
