Finkle B S, Caplan Y H, Garriott J C, Monforte J R, Shaw R F, Sonsalla P K
J Forensic Sci. 1981 Oct;26(4):739-57.
A total of 1859 cases provides the basis for this study in which propoxyphene, and often its major metabolite, was demonstrated by toxicological analysis in the blood or tissues of the deceased at 27 medical examiner or coroner's offices across the United States and Canada. The study period includes the last five months of 1975 through December 1978. The cases describe a clearly defined adult population with a marked tendency toward hypochondria, chronic minor illness, and severe psychiatric problems. The high proportion of suicides (44.1% of the total cases and 54.0% of the drug-caused deaths) and multiple-drug toxicities (88.6%) suggests that the involvement of propoxyphene in many of these fatalities may be of less significance than the phenomenon of "polypharmacy" and self-medication without appropriate medical supervision. This evaluation of propoxyphene provides no evidence that propoxyphene is responsible for "street-drug" fatalities. Its appearance in postmortem toxicological examinations has been declining sharply since 1977, but it continues to be dangerous when used excessively, particularly in combination with alcohol and other central nervous system depressant drugs.
共有1859个案例为该研究提供了依据。在美国和加拿大的27个法医或验尸官办公室，通过毒理学分析在死者的血液或组织中证实了丙氧芬及其主要代谢物的存在。研究时间段为1975年的最后五个月至1978年12月。这些案例描述了一个明确界定的成年人群体，他们有明显的疑病症、慢性轻症和严重精神问题倾向。自杀比例高（占总案例的44.1%，占药物致死案例的54.0%）以及多药中毒比例高（88.6%）表明，丙氧芬在许多这些死亡案例中的作用可能不如“多药并用”和在没有适当医疗监督的情况下自我用药的现象重要。对丙氧芬的这种评估没有提供证据表明丙氧芬是“街头毒品”致死的原因。自1977年以来，它在死后毒理学检查中的出现率一直在急剧下降，但过量使用时仍然危险，特别是与酒精和其他中枢神经系统抑制药物合用时。
