Miami-Dade Medical Examiner Department, Toxicology Laboratory, Miami, Florida, USA.
J Forensic Sci. 2023 Nov;68(6):2205-2210. doi: 10.1111/1556-4029.15375. Epub 2023 Sep 1.
Xylazine sedative, muscle relaxant, and analgesic used in a veterinary setting. Although xylazine was never approved for therapeutic use in humans, it has become popular in the street drug market as a cutting or bulking agent in the fentanyl and heroin supply. Recently, there has been a significant increase in the detection of xylazine in postmortem forensic toxicology casework. Xylazine can be identified during routine toxicology screening utilizing instrumentation such as gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry. Using the Miami-Dade Medical Examiner's LIMS system, all cases received between 2015 and 2022 in which xylazine was reported were reviewed. The cases studied include accidental drug overdose deaths in Miami-Dade County as well as Collier County (Naples), Florida. In total, there are 170 cases; the majority are accidental polydrug overdoses involving White males between the ages of 25 and 44 years old. Of the 170 cases, 37% listed xylazine as the cause of death. 13% of cases contained only xylazine and fentanyl while the remaining 87% of deaths were attributed to polydrug toxicity involving two or more substances. The prevalence of xylazine can be attributed to its increasing popularity rather than an increase in caseload. In 2019, xylazine was present in only 4% of all accidental fentanyl overdoses. By 2021, this percentage has increased sixfold, with xylazine present in 24% of all accidental fentanyl overdoses. Despite a decrease in fentanyl overdoses in 2022, the percentage of xylazine detection remained the same.
苯环己哌啶（苯环己哌啶酮），兽医镇静、肌肉松弛和镇痛剂。尽管苯环己哌啶从未获准在人体中用于治疗，但它已在街头毒品市场上作为芬太尼和海洛因供应的切割剂或增稠剂而流行。最近，在法医毒理学案例工作中，苯环己哌啶的检测明显增加。苯环己哌啶可以通过气相色谱-质谱联用仪和液相色谱-质谱联用仪等仪器进行常规毒理学筛选来识别。利用迈阿密-戴德医疗检验员的 LIMS 系统，回顾了 2015 年至 2022 年间报告有苯环己哌啶的所有病例。研究的病例包括迈阿密-戴德县以及佛罗里达州科利尔县（那不勒斯）的意外药物过量死亡。共有 170 例；大多数是涉及年龄在 25 至 44 岁之间的白人男性的意外多种药物过量。在 170 例中，37%的病例将苯环己哌啶列为死亡原因。13%的病例仅含有苯环己哌啶和芬太尼，而其余 87%的死亡归因于涉及两种或两种以上物质的多种药物毒性。苯环己哌啶的流行可归因于其日益普及，而不是案件数量的增加。2019 年，苯环己哌啶仅出现在所有意外芬太尼过量的 4%病例中。到 2021 年，这一比例增加了六倍，苯环己哌啶出现在所有意外芬太尼过量的 24%病例中。尽管 2022 年芬太尼过量有所减少，但苯环己哌啶的检测百分比保持不变。
