Ahlner Johan, Holmgren Anita, Jones Alan Wayne
Department of Forensic Genetics and Forensic Toxicology, Swedish National Board of Forensic Medicine, Linköping, Sweden; Department of Clinical Pharmacology, Faculty of Medicine, Linköping University, Linköping, Sweden.
Department of Forensic Genetics and Forensic Toxicology, Swedish National Board of Forensic Medicine, Linköping, Sweden.
Forensic Sci Int. 2016 Aug;265:138-43. doi: 10.1016/j.forsciint.2016.01.036. Epub 2016 Feb 3.
Multiple arrests for use of illicit drugs and/or impaired driving strongly suggests the existence of a personality disorder and/or a substance abuse problem.
This retrospective study (1993-2010) used a national forensic toxicology database (TOXBASE), and we identified 3943 individuals with two or more arrests for use of illicit drugs and/or impaired driving. These individuals had subsequently died from a fatal drug poisoning or some other cause of death, such as trauma.
Of the 3943 repeat offenders 1807 (46%) died from a fatal drug overdose and 2136 (54%) died from other causes (p<0.001). The repeat offenders were predominantly male (90% vs 10%) and mean age of drug poisoning deaths was 5 y younger (mean 35 y) than other causes of death (mean 40 y). Significantly more repeat offenders (46%) died from drug overdose compared with all other forensic autopsies (14%) (p<0.001). Four or more drugs were identified in femoral blood in 44% of deaths from poisoning (drug overdose) compared with 18% of deaths by other causes (p<0.001). The manner of death was considered accidental in 54% of deaths among repeat offenders compared with 28% for other suspicious deaths (p<0.001). The psychoactive substances most commonly identified in autopsy blood from repeat offenders were ethanol, morphine (from heroin), diazepam, amphetamines, cannabis, and various opioids.
This study shows that people arrested multiple times for use of illicit drugs and/or impaired driving are more likely to die by accidentally overdosing with drugs. Lives might be saved if repeat offenders were sentenced to treatment and rehabilitation for their drug abuse problem instead of conventional penalties for drug-related crimes.
因使用非法药物和/或酒驾而多次被捕强烈表明存在人格障碍和/或药物滥用问题。
这项回顾性研究（1993 - 2010年）使用了一个国家法医毒理学数据库（TOXBASE），我们识别出3943名因使用非法药物和/或酒驾而被捕两次或更多次的个体。这些个体随后死于致命药物中毒或其他死因，如外伤。
在这3943名惯犯中，1807人（46%）死于致命药物过量，2136人（54%）死于其他原因（p<0.001）。惯犯中男性占主导（90%对10%），药物中毒死亡的平均年龄比其他死因的平均年龄小5岁（分别为平均35岁和平均40岁）。与所有其他法医尸检（14%）相比，显著更多的惯犯（46%）死于药物过量（p<0.001）。在因中毒（药物过量）死亡的案例中，44%的死者股血中检测出四种或更多药物，而其他死因的这一比例为18%（p<0.001）。惯犯死亡案例中54%的死亡方式被认定为意外，而其他可疑死亡案例中这一比例为28%（p<0.001）。在惯犯尸检血液中最常检测到的精神活性物质有乙醇、吗啡（来自海洛因）、地西泮、苯丙胺、大麻和各种阿片类药物。
这项研究表明，因使用非法药物和/或酒驾而多次被捕的人更有可能死于意外药物过量。如果惯犯因药物滥用问题被判处治疗和康复，而不是对与毒品相关的犯罪处以传统刑罚，可能会挽救生命。
