Section of Forensic Chemistry, Department of Forensic Medicine, Faculty of Health Sciences, University of Copenhagen, Frederik V's vej 11, 3, DK-2100, Copenhagen, Denmark.
Forensic Toxicology Unit, Finnish Institute for Health and Welfare, P.O. Box 30, FI-00271, Helsinki, Finland; Department of Forensic Medicine, University of Helsinki, P.O. Box 40, FI-00014, Helsinki, Finland.
Forensic Sci Int. 2020 Aug;313:110343. doi: 10.1016/j.forsciint.2020.110343. Epub 2020 May 20.
This study is the seventh report on fatal poisonings among drug addicts in the Nordic countries. In this report, we analyse data from the five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden. Data on gender, number of deaths, places of deaths, age, main intoxicants and substances detected in blood were recorded to obtain national and comparable Nordic data, and to allow comparison with earlier studies conducted in 1984, 1991, 1997, 2002, 2007 and 2012. The death rate (number of deaths per 100,000 inhabitants) was highest in Iceland (6.58) followed closely by Sweden (6.46) and then lowest in Denmark (4.29). The death rate increased in Finland (5.84), Iceland and Sweden and decreased in Denmark compared to earlier studies. The death rate in Norway, which has decreased since 2002, has stabilised around 5.7 as of 2017. Women accounted for 7-23% of the fatal poisonings. The percentage was lowest in Iceland and highest in Finland and Norway. The age range was 14-70 years. The median age (41 years) was highest in Denmark and Norway. The other countries had a median age between 33 and 35 years. Opioids were the main cause of death. Methadone remained the main intoxicant in Denmark, while heroin/morphine was still the main intoxicant in Norway, as was buprenorphine in Finland. However, the picture has changed in Sweden compared to 2012, where heroin/morphine caused most deaths in 2017. Sweden also experienced the highest number of deaths from fentanyl analogues (67 deaths) and buprenorphine (61 deaths). Deaths from fentanyl analogues also occurred in Denmark, Finland and Norway, but to a smaller extent. Over the years, the proportion of opioid deaths has decreased in all countries except Sweden, which has experienced an increase. This decline has been replaced by deaths from CNS stimulants like cocaine, amphetamine and methylenedioxymethamphetamine (MDMA). Cocaine deaths have occurred in all countries but most frequently in Denmark. MDMA deaths have increased in all countries but mostly in Finland. Poly-drug use was widespread, as seen in the earlier studies. The median number of detected drugs per case varied from 4-6. Heroin/morphine, methadone, buprenorphine, cocaine, amphetamine, methamphetamine, MDMA, tetrahydrocannabinol (THC) and benzodiazepines were frequently detected. Pregabalin and gabapentin were detected in all countries, especially pregabalin, which was detected in 42% of the Finnish cases. New psychoactive substances (NPS) occurred in all countries except Iceland.
本研究是北欧国家第七次报告吸毒者致命中毒情况。本报告分析了丹麦、芬兰、冰岛、挪威和瑞典这五个北欧国家的数据。记录了性别、死亡人数、死亡地点、年龄、主要毒物和血液中检测到的物质等数据，以获取国家和可比的北欧数据，并允许与 1984 年、1991 年、1997 年、2002 年、2007 年和 2012 年进行的早期研究进行比较。（每 10 万居民中的死亡人数）死亡率最高的是冰岛（6.58），其次是瑞典（6.46），丹麦最低（4.29）。与早期研究相比，芬兰（5.84）、冰岛和瑞典的死亡率上升，而丹麦的死亡率下降。自 2002 年以来，挪威的死亡率一直在下降，截至 2017 年，已稳定在 5.7 左右。女性占致命中毒的 7-23%。冰岛的比例最低，芬兰和挪威的比例最高。年龄范围为 14-70 岁。丹麦和挪威的中位年龄（41 岁）最高。其他国家的中位年龄在 33 到 35 岁之间。阿片类药物是主要死因。美沙酮仍然是丹麦的主要毒物，而海洛因/吗啡仍然是挪威的主要毒物，芬太尼类药物仍然是芬兰的主要毒物。然而，与 2012 年相比，瑞典的情况发生了变化，2017 年海洛因/吗啡导致的死亡人数最多。瑞典还经历了芬太尼类似物（67 人死亡）和丁丙诺啡（61 人死亡）死亡人数最多。丹麦、芬兰和挪威也发生了芬太尼类似物死亡，但程度较小。多年来，除瑞典外，所有国家的阿片类药物死亡人数都有所下降，而瑞典的死亡人数则有所上升。这种下降被可卡因、苯丙胺和 3,4-亚甲基二氧甲基苯丙胺（MDMA）等中枢神经系统兴奋剂引起的死亡所取代。所有国家都发生了可卡因死亡，但在丹麦最为常见。所有国家的 MDMA 死亡人数都有所增加，但主要是在芬兰。多药物使用很普遍，与早期研究一样。每例病例检测到的药物中位数从 4-6 种不等。海洛因/吗啡、美沙酮、丁丙诺啡、可卡因、苯丙胺、甲基苯丙胺、MDMA、四氢大麻酚（THC）和苯二氮䓬类药物经常被检测到。普瑞巴林和加巴喷丁在所有国家都有检测到，特别是普瑞巴林，在芬兰的病例中有 42%被检测到。新精神活性物质（NPS）在除冰岛以外的所有国家都有发生。
