Dallas County Southwestern Institute of Forensic Sciences, Dallas, Texas, USA.
J Forensic Sci. 2023 Jan;68(1):222-232. doi: 10.1111/1556-4029.15155. Epub 2022 Oct 27.
The opioid epidemic resulted in an increase in identifications of fentanyl, fentanyl analogs, and heroin, among other opioids, in the toxicology and seized drug analysis fields over the past several years. The Dallas County Southwestern Institute of Forensic Sciences, comprised of the Toxicology Laboratory and Drug Analysis Laboratory, observed a rise in fentanyl-positive analyses in both laboratories. Fentanyl positivity increased from 1.1% to 3.4% in the Toxicology Laboratory over the five years of this study, whereas 6-monoacetylmorphine (6-MAM) positivity remained relatively stable at approximately 2%. Similarly, in the Drug Analysis Laboratory, the fentanyl positivity rate changed from 0.03% to 0.60%, whereas heroin identification remained stable at approximately 8-9%. Based on data obtained from toxicology submissions, a typical fentanyl or heroin user was a white male in their late 30s. The average concentration of fentanyl in postmortem cases, antemortem cases, and 6-MAM in postmortem specimens was 9.7 ng/ml, 5.5 ng/ml, and 68.4 ng/ml, respectively. Poly-drug use was evident, with benzodiazepines being the most commonly co-administered drug with fentanyl (49.4%). Multiple drugs were identified via analysis of clandestine tablets submitted to the Drug Analysis Laboratory, including fentanyl and/or heroin in combination with compounds such as cocaine, etizolam, and acetaminophen. The most frequently identified clandestine tablet was "M367," typically manufactured to contain acetaminophen and hydrocodone, but was found to contain fentanyl or heroin. The results from this study aid in the understanding of the current opioid trends in Dallas County and provides an opportunity for comparison to other populations and geographical regions.
在过去几年中，毒理学和缴获毒品分析领域中鉴定出的芬太尼、芬太尼类似物和海洛因等其他阿片类药物有所增加，这是阿片类药物流行的结果。达拉斯县西南法医科学研究所由毒理学实验室和药物分析实验室组成，这两个实验室都观察到芬太尼阳性分析的增加。在这项研究的五年中，毒理学实验室中芬太尼阳性率从 1.1%上升到 3.4%，而 6-单乙酰吗啡（6-MAM）阳性率相对稳定在 2%左右。同样，在药物分析实验室中，芬太尼阳性率从 0.03%上升到 0.60%，而海洛因鉴定率保持稳定，约为 8-9%。根据毒理学报告获得的数据，典型的芬太尼或海洛因使用者是 30 多岁的白人男性。死后案例中芬太尼的平均浓度、生前案例中芬太尼的平均浓度和死后样本中 6-MAM 的平均浓度分别为 9.7ng/ml、5.5ng/ml 和 68.4ng/ml。多药物使用很明显，苯二氮䓬类药物是与芬太尼最常联合使用的药物（49.4%）。通过对提交给药物分析实验室的秘密片剂进行分析，发现了多种药物，包括芬太尼和/或海洛因与可卡因、依替唑仑和对乙酰氨基酚等化合物的组合。最常被识别的秘密片剂是“M367”，通常含有对乙酰氨基酚和氢可酮，但被发现含有芬太尼或海洛因。这项研究的结果有助于了解达拉斯县目前的阿片类药物趋势，并为与其他人群和地理区域进行比较提供了机会。
