Almeida-González Maira, Boada Luis D, Henríquez-Hernández Luis Alberto, Luzardo Octavio P, Zaragoza Enrique, Burillo-Putze Guillermo, Quintana-Montesdeoca María P, Zumbado Manuel
Institute of Legal Medicine of Las Palmas, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain.
Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain.
Toxics. 2022 Feb 1;10(2):64. doi: 10.3390/toxics10020064.
Medical psychotropics are widely used and prescribed in developed countries. These medications may have an impairing effect on mood or perception and may induce harmful behaviors. Nevertheless, in Europe, studies on their importance from a medico-legal perspective are scarce. To fill this gap, we evaluate the determinants of these drugs in a retrospective study based on data obtained from forensic autopsies. Toxicological analyses were performed on 394 blood samples from compulsory autopsies at the Institute of Legal Medicine of Las Palmas. Of the samples, 41% (159) were positive for at least one psychotropic, with benzodiazepines being the most frequently detected (24.1%), followed by opiates and antidepressants. Benzodiazepines, opiates, and antidepressants were detected more frequently in men who suffered a violent death. More than 30% of the positive samples showed two or more drugs, suggesting a prevalence of polypharmacy among forensic autopsy subjects, with the most frequently combination found being benzodiazepines plus opiates (28.3% of positive samples). A combination of opiates plus antidepressants was also found in subjects involved in violent deaths. Our results suggest that more than 40% of the adult European population involved in medico-legal issues may be under the influence of legal psychotropics. The link between violent deaths and the use of medical psychotropics is particularly worrisome and indicates that these drugs should be carefully monitored in developed countries, in all forensic autopsies, in a similar way to illegal psychotropics.
精神类药物在发达国家被广泛使用和开具处方。这些药物可能会对情绪或感知产生损害作用，并可能引发有害行为。然而，在欧洲，从法医学角度对其重要性的研究却很匮乏。为填补这一空白，我们在一项回顾性研究中，基于从法医尸检获得的数据，评估了这些药物的决定因素。对拉斯帕尔马斯法医学研究所强制尸检的394份血样进行了毒理学分析。在这些样本中，41%（159份）至少对一种精神类药物呈阳性反应，其中苯二氮䓬类药物检测频率最高（24.1%），其次是阿片类药物和抗抑郁药。在暴力死亡的男性中，苯二氮䓬类药物、阿片类药物和抗抑郁药的检测频率更高。超过30%的阳性样本显示含有两种或更多药物，这表明法医尸检对象中存在多药合用的普遍情况，最常见的组合是苯二氮䓬类药物加阿片类药物（占阳性样本的28.3%）。在涉及暴力死亡的对象中也发现了阿片类药物加抗抑郁药的组合。我们的结果表明，超过40%涉及法医学问题的成年欧洲人口可能受到合法精神类药物的影响。暴力死亡与使用精神类药物之间的联系尤其令人担忧，这表明在发达国家，在所有法医尸检中，应像对非法精神类药物一样，对这些药物进行仔细监测。
