Pelletti Guido, Garagnani Marco, Rossi Francesca, Roffi Raffaella, Banchini Antonio, Pelotti Susi
Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126, Bologna, Italy.
Department of Medicine and Surgery (DiMec), University of Parma, Via A. Gramsci 14, 43126, Parma, Italy.
Forensic Sci Med Pathol. 2018 Dec;14(4):442-449. doi: 10.1007/s12024-018-0010-y. Epub 2018 Aug 11.
Toxicological analyses are often performed in drug-facilitated sexual assaults (DFSA), when the victim shows or reports impaired consciousness and reduced ability. However, in other crimes or fatalities, especially in cases of concurrent natural disease or when another likely cause of death has been established, the involvement of drugs can be overlooked. The aim of this study is to report a series of cases of (i) victims of drug-facilitated crimes (DFC) other than DFSA and (ii) victims of acute intoxications, in which "licit" psychoactive drugs were found in blood samples, with the aim of understanding in which circumstances and to what extent prescription drugs have been used for non-medical purposes in recent Italian casuistry. Circumstantial, autopsy, and toxicological data were collected through a retrospective analysis performed between 2013 and 2017 in the Forensic Toxicology Unit of the University of Bologna. Cases of "DFC other than DFSA" and "Acute Intoxication" in which "psychoactive drugs" or "prescription drugs" or "licit drugs" were found in the blood samples of the victims were included in the study. Nine cases of DFC other than DFSA, and 11 cases of acute intoxication, were identified. Different categories of "licit" psychoactive drugs (e.g. hypnotics, antipsychotics, antidepressants, anticonvulsants) had been used to facilitate diverse types of crime (homicide, robberies, elder abuse, fatal poisoning) or acute intoxication (suicide, attempted suicide, accidental death). The circumstances of these cases, as well as toxicological findings in blood samples and other relevant forensic elements, are reported, summarized and discussed in this paper. The non-medical use of pharmaceuticals has been identified by recent forensic literature and the present study as a significant and growing phenomenon, and its implication in fatalities should be taken into consideration and accurately investigated through appropriate toxicological analysis. Our study presents an overview of the circumstances of non-medical use of prescription drugs, usually considered "safe drugs", and their involvement in cases of DFC, suicides and accidental intoxication. In order to estimate the real incidence of these medications in DFC and acute intoxication, and thus collect more analytical and contextual data, further studies are needed, along with effective cooperation among police officers, clinicians, forensic pathologists, and toxicologists.
在药物辅助性性侵案件（DFSA）中，当受害者表现出或报告意识受损及能力下降时，通常会进行毒理学分析。然而，在其他犯罪或死亡案件中，尤其是存在并发自然疾病的情况或已确定另一个可能的死因时，药物的参与可能会被忽视。本研究的目的是报告一系列案件，包括（i）除DFSA之外的药物辅助犯罪（DFC）受害者，以及（ii）急性中毒受害者，在这些受害者的血液样本中发现了“合法”的精神活性药物，目的是了解在何种情况下以及在最近的意大利案例中处方药被用于非医疗目的的程度。通过对2013年至2017年期间在博洛尼亚大学法医毒理学部门进行的回顾性分析，收集了相关的情况、尸检和毒理学数据。受害者血液样本中发现“精神活性药物”或“处方药”或“合法药物”的“除DFSA之外的DFC”和“急性中毒”案件被纳入研究。确定了9起除DFSA之外的DFC案件和11起急性中毒案件。不同类别的“合法”精神活性药物（如催眠药、抗精神病药、抗抑郁药、抗惊厥药）被用于促成各种类型的犯罪（杀人、抢劫、虐待老人、致命中毒）或急性中毒（自杀、自杀未遂、意外死亡）。本文报告、总结并讨论了这些案件的情况，以及血液样本中的毒理学发现和其他相关法医要素。近期法医文献和本研究已确定药品的非医疗使用是一个显著且不断增长的现象，其在死亡事件中的影响应予以考虑，并通过适当的毒理学分析进行准确调查。我们的研究概述了通常被认为是“安全药物”的处方药的非医疗使用情况，以及它们在DFC、自杀和意外中毒案件中的参与情况。为了估计这些药物在DFC和急性中毒中的实际发生率，从而收集更多的分析和背景数据，需要进一步开展研究，并需要警察、临床医生、法医病理学家和毒理学家之间进行有效合作。
