Haberman P W, Noble J A, Dufour M C
Division of Biometry and Epidemiology, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland 20892-7003, USA.
J Stud Alcohol. 1995 May;56(3):344-7. doi: 10.15288/jsa.1995.56.344.
The purpose of this review of all appropriate, available medical examiner (ME) studies is to provide information on cases with positive toxicologies for cocaine, morphine (the heroin metabolite) and methadone that have positive blood or brain alcohol concentrations (BACs).
Criteria for inclusion of U.S. ME studies in this review are (1) at least 20 cases with a positive toxicology for cocaine, morphine or methadone and (2) BAC test findings according to specific drug positivity. Only 19 studies conducted from 1969 to 1992 met these criteria; most studies reviewed were not included primarily because of their failure to present or link available BAC test findings with positive toxicologies for these other drugs.
The BAC-positive ranges were similar for cocaine and heroin. In reports on both heroin and methadone or on all three drugs, heroin-positive cases had the highest proportions and methadone-positive cases had the lowest proportions with positive BACs.
Published data confirm the substantial presence of alcohol in combination with cocaine, heroin and methadone among ME cases. Future ME studies should endeavor to link BAC and toxicology findings for other drugs according to drug-induced or drug-related manner of death. These data would advance our knowledge about the role of alcohol in drug deaths and provide additional information on substance abuse trends.
本次对所有适当的、可得的法医（ME）研究进行综述的目的是，提供有关可卡因、吗啡（海洛因代谢物）和美沙酮毒理学检测呈阳性且血液或大脑酒精浓度（BAC）呈阳性的案例信息。
纳入本次综述的美国法医研究标准为：（1）至少20例可卡因、吗啡或美沙酮毒理学检测呈阳性的案例；（2）根据特定药物阳性情况得出的BAC检测结果。1969年至1992年进行的研究中只有19项符合这些标准；大多数被综述的研究未被纳入主要是因为它们未能呈现或关联可得的BAC检测结果与这些其他药物的阳性毒理学结果。
可卡因和海洛因的BAC阳性范围相似。在关于海洛因和美沙酮或所有三种药物的报告中，海洛因阳性案例中BAC呈阳性的比例最高，美沙酮阳性案例中BAC呈阳性的比例最低。
已发表的数据证实，在法医案例中，酒精大量与可卡因、海洛因和美沙酮同时存在。未来的法医研究应努力根据药物导致的或与药物相关的死亡方式，将BAC与其他药物的毒理学结果联系起来。这些数据将增进我们对酒精在药物死亡中作用的了解，并提供有关药物滥用趋势的更多信息。
