Kopra Emma I, Penttinen Jenni, Rucker James J, Copeland Caroline S
Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King's College London, London, UK.
Prog Neuropsychopharmacol Biol Psychiatry. 2025 Jan 10;136:111177. doi: 10.1016/j.pnpbp.2024.111177. Epub 2024 Oct 20.
Psychedelic drugs are increasingly visible in society once more, but their risks and adverse effects have received less attention than perhaps they should. While fatalities associated with psychedelics appear rare, a systematic approach to characterising their aetiology is required to inform harm minimisation efforts.
This study aimed to analyse prevalence and characteristics of psychedelic-related deaths in England, Wales, and Northern Ireland, between 1997 and 2022.
We analysed coroner reports submitted to the National Programme on Substance Use Mortality where psychedelic serotonergic agonist drugs were involved in the death, and conducted a thematic framework analysis to explore potential factors associated with their occurrence.
We identified 28 cases where psychedelics were implicated (75 %, N = 21) or potentially implicated (25 %, N = 7) in the death; 19 of these involving psychedelic tryptamines (LSD 39 %, N = 11; Psilocybin 21 %, N = 6; DMT 7 %, N = 2), and 9 psychedelic phenethylamines (incl. NBOMes 18 %, N = 5). Most deaths were deemed accidental by the coroner (86 %, N = 24), including both traumatic injuries and drug toxicities; most cases involved multiple implicated drugs (68 %, N = 19); and most of the deceased were under 30 years of age (82 %, N = 23). Thematic framework analysis identified nine themes in the deaths across three categories. 'Polysubstance use' was the most common theme (82 % of cases, N = 23/28), followed by a suboptimal 'physical environment' (70 % of cases where this information was available, N = 14/20).
The profound and often unpredictable effects of psychedelics pose a unique profile of risks and adverse reactions. Nevertheless, psychedelic-related deaths remain very rare in comparison to other recreational drugs, and frequently involve polydrug use. Implications for harm reduction and policy are discussed.
迷幻药物在社会上再次日益常见，但其风险和不良反应受到的关注或许比应有的要少。虽然与迷幻药物相关的死亡似乎罕见，但需要一种系统的方法来描述其病因，以便为减少伤害的努力提供依据。
本研究旨在分析1997年至2022年期间英格兰、威尔士和北爱尔兰与迷幻药物相关的死亡的发生率和特征。
我们分析了提交给国家药物使用死亡率计划的验尸官报告，这些报告中迷幻血清素能激动剂药物与死亡有关，并进行了主题框架分析，以探索与其发生相关的潜在因素。
我们确定了28例迷幻药物与死亡有关（75%，N = 21）或可能有关（25%，N = 7）的案例；其中19例涉及迷幻色胺类药物（麦角酸二乙胺39%，N = 11；裸盖菇素21%，N = 6；二甲基色胺7%，N = 2），9例涉及迷幻苯乙胺类药物（包括N-亚苄基苯乙胺18%，N = 5）。验尸官判定大多数死亡为意外（86%，N = 24），包括创伤性损伤和药物毒性；大多数案例涉及多种相关药物（68%，N = 19）；并且大多数死者年龄在30岁以下（82%，N = 23）。主题框架分析在死亡案例中确定了三个类别下的九个主题。“多药使用”是最常见的主题（82%的案例，N = 23/28），其次是不理想的“物理环境”（在有此信息的案例中占70%，N = 14/20）。
迷幻药物深远且往往不可预测的影响构成了独特的风险和不良反应特征。然而，与其他娱乐性药物相比，与迷幻药物相关的死亡仍然非常罕见，并且经常涉及多药使用。讨论了对减少伤害和政策的影响。
