Dwyer P S, Jones I F
Hum Toxicol. 1984 Aug;3 Suppl:145S-174S. doi: 10.1177/096032718400300115.
Coroners' files have been examined to ascertain the numbers of deaths involving self-poisoning with analgesic drugs with specific reference to the paracetamol/dextropropoxyphene combination. The period of study was 1976-1980. This report concentrates on cases in England, although reference is made to similar deaths occurring in Scotland and Northern Ireland. Data have been collected extensively on a wide range of issues concerning fatal self-poisonings mainly by visiting coroners' offices in England to make direct investigation of records. The total number of cases where the paracetamol/dextropropoxyphene combination can be considered as ingested in the self-poisoning episode is underestimated. The number of cases involving alcohol and/or other drugs taken together with the combination product is particularly underestimated. Involvement of people aged 30 years and below comprises 32% of all cases. 'Gesture' overdoses comprise an estimated 14% of all cases in England. An analysis of fatalities from cases where quantities in post-mortem blood of dextropropoxyphene less than 1 microgram/ml and paracetamol less than 50 micrograms/ml are found and of cases where death occurs within 2 h of ingestion of the overdose has been carried out. The results are inconclusive. In most cases alcohol and/or other drugs are found to be involved. Critical inspection of coroners' files shows relatively few of these cases where the combination product is ingested on its own. There is wide variability in the data available in coroners' files. In many cases data of value to this research are not recorded. Medical history and quantitative levels of drugs suspected (particularly dextropropoxyphene) are particular examples of factors which may not be recorded. Office of Population, Censuses and Surveys (OPCS) mortality data are based on certified causes of death. Because of the underestimate of the involvement of this combination product and the under-reporting of other drug and/or alcohol ingestion with the combination, care must be exercised in quoting or drawing conclusions from OPCS statistics.
已查阅死因裁判官档案，以确定涉及使用镇痛药自我中毒死亡的人数，尤其关注对乙酰氨基酚/右丙氧芬组合。研究时间段为1976年至1980年。本报告主要关注英格兰的案例，尽管也提及了在苏格兰和北爱尔兰发生的类似死亡案例。主要通过走访英格兰的死因裁判官办公室直接调查记录，广泛收集了有关致命性自我中毒的各种问题的数据。对乙酰氨基酚/右丙氧芬组合在自我中毒事件中被认为已摄入的案例总数被低估。与该组合产品一起服用酒精和/或其他药物的案例数量尤其被低估。30岁及以下人群的案例占所有案例的32%。“象征性”过量服药估计占英格兰所有案例的14%。对死后血液中右丙氧芬含量低于1微克/毫升且对乙酰氨基酚含量低于50微克/毫升的案例以及过量服药后2小时内死亡的案例进行了死亡分析。结果尚无定论。在大多数案例中，发现涉及酒精和/或其他药物。对死因裁判官档案的严格审查表明，单独服用该组合产品的案例相对较少。死因裁判官档案中的可用数据存在很大差异。在许多案例中，对本研究有价值的数据未被记录。病史以及疑似药物（尤其是右丙氧芬）的定量水平就是可能未被记录的因素的具体例子。人口普查与调查办公室（OPCS）的死亡率数据基于经认证的死亡原因。由于该组合产品的参与情况被低估，且与该组合一起服用其他药物和/或酒精的情况报告不足，因此在引用OPCS统计数据或从中得出结论时必须谨慎。
