Darke Shane, Duflou Johan, Peacock Amy, Farrell Michael, Lappin Julia
National Drug & Alcohol Research Centre, University of New South Wales, NSW 2052, Australia.
Sydney Medical School, University of Sydney, NSW, Australia.
Drug Alcohol Depend Rep. 2024 Jan 20;10:100217. doi: 10.1016/j.dadr.2024.100217. eCollection 2024 Mar.
The age of people who use illicit opioids has increased, with a clinical picture of accelerated ageing. The study aimed to determine, stratified by age: 1. The circumstances and characteristics of heroin-related toxicity deaths in Australia, 2020-2022; 2. The toxicological profile and autopsy findings; 3. The proportion of cases in which blood 6-acetyl morphine (6AM) was detected, as a measure of survival time.
Retrospective study of 610 cases of fatal heroin-related drug toxicity in Australia, 2020-2022. Cases were stratified as: <30 years, 30-39 years, 40-49 years, ≥50 years.
Compared to the youngest group, those aged ≥50 years were more likely to have a history of chronic pain (12.4 v 3.3 %), to have their death attributed to combined drug toxicity/disease (20.1 v 3.3 %), and to have evidence of a sudden collapse (21.3 v 11.1 %). There were no differences in free morphine concentrations or glucuronide concentrations. Compared to the youngest group, however, the two older groups were significantly more likely to have 6AM present in blood, a proxy measure of a shorter survival time (52.0, 55.2 v 34.5 %). Compared to the youngest group, cases aged ≥50 years were more likely to be diagnosed with cardiomegaly (44.0 v 16.7 %), coronary artery disease (46.0 v 15.0 %), emphysema (35.0 v 5.1 %), hepatic steatosis (15.4 v 3.4 %), hepatic fibrosis (17.6 v 3.4 %), and cirrhosis (19.8 v 0.0 %).
Older cases of heroin overdose had more extensive heart, lung, and liver disease, and appeared more likely to have shorter survival times.
使用非法阿片类药物的人群年龄有所增加，呈现出加速衰老的临床症状。本研究旨在按年龄分层确定：1. 2020 - 2022年澳大利亚与海洛因相关的中毒死亡情况及特征；2. 毒理学特征和尸检结果；3. 检测出血液中6 - 乙酰吗啡（6AM）的病例比例，以此作为生存时间的一项指标。
对2020 - 2022年澳大利亚610例与海洛因相关的致命药物中毒病例进行回顾性研究。病例分为：<30岁、30 - 39岁、40 - 49岁、≥50岁。
与最年轻组相比，≥50岁的人群更有可能有慢性疼痛病史（12.4%对3.3%），死亡归因于合并药物毒性/疾病的可能性更高（20.1%对3.3%），且有突然晕倒的证据（21.3%对11.1%）。游离吗啡浓度或葡萄糖醛酸浓度无差异。然而，与最年轻组相比，年龄较大的两组血液中出现6AM的可能性显著更高，这是生存时间较短的一项替代指标（52.0%、55.2%对34.5%）。与最年轻组相比，≥50岁的病例更有可能被诊断为心脏肥大（44.0%对16.7%）、冠状动脉疾病（46.0%对15.0%）、肺气肿（35.0%对5.1%）、肝脂肪变性（15.4%对3.4%）、肝纤维化（17.6%对3.4%）和肝硬化（19.8%对0.0%）。
年龄较大的海洛因过量病例有更广泛的心脏、肺部和肝脏疾病，且生存时间似乎更短。
