Forensic toxicology analysis of self-poisoning suicidal deaths in Tehran, Iran; trends between 2011-2015

Kordrostami, Roya; Akhgari, Maryam; Ameri, Maryam; Ghadipasha, Masoud; Ali, Kamran

doi:10.1186/s40199-017-0181-1

Cited by 43 publications

(41 citation statements)

References 61 publications

(81 reference statements)

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“…The cause of death of 10 cases in the present study was suicidal death with toxic agents. Our findings provide more evidence for the other studies, in that there is a strong association between drug abuse and suicidal ideation .…”

Section: Discussionsupporting

confidence: 82%

“…It may be suggested that the cause of death of many cases in the current study was the cardiotoxic effect of methadone ameliorated by concomitant use of methamphetamine. Non‐medical use of pharmaceutical drugs is a significant problem in many countries and Iran . Replacement of illicit drugs with psychoactive prescription drugs (methadone, tramadol and buprenorphine) has led to greater demand for addiction treatment and also death .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Forensic Toxicology Perspectives of Methadone‐associated Deaths in Tehran, Iran, a 7‐year Overview

Akhgari

Amini-Shirazi

Iravani

2017

Basic Clin Pharma Tox

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Methadone has a long history of pain relief and successful substitute for maintenance treatment in heroin and narcotic addiction. The aim of the study was to assess the trends of methadone-associated deaths in Tehran, Iran, in 2009-2015, from a forensic toxicology point of view. All methadone-associated deaths during this 7-year study period were evaluated according to demographic parameters and forensic toxicology analysis results. Results showed that 1274 cases of methadone-associated deaths were investigated during the study period. The incidence rate of methadone-associated deaths had risen 7.7 times in 2015 in comparison with 2009 (p < 0.05). The majority of cases were men (90.35%), aged from 20 to 40 years. About 80% of cases had shown positive results for other drugs and poisons in combination with methadone. Methamphetamine and tramadol were the most drugs detected in post-mortem samples. Death rates among methadone users in Tehran, Iran, increased year by year during 2009-2015. These findings raise the attention to the concomitant use of drugs with the need for changes in regulation and regulatory policy to restrict access and use of controlled drugs.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Forensic Toxicology Perspectives of Methadone‐associated Deaths in Tehran, Iran, a 7‐year Overview

Akhgari

Amini-Shirazi

Iravani

2017

Basic Clin Pharma Tox

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“…For toxicological analysis, urine samples were extracted by liquid-liquid extraction (LLE) in systematic toxicological analysis (STA) manner for screening drugs, poisons, and opioids (Kordrostami et al 2017). As novel psychoactive substances are not available and routinely used in Iran, we did not search for them in biological specimens.…”

Section: Methodsmentioning

confidence: 99%

“…As many drugs of forensic interest have alkaline chemical structure, the pH of the urine sample was adjusted to basic (pH = 12) for efficient extraction of alkaline drugs such as narcotic analgesics, benzodiazepines, and ATS. Careful adjustment of pH to 8.5-9 was needed for the extraction of amphoteric drugs such as morphine using LLE method (Kordrostami et al 2017). For the extraction of acidic drugs such as phenytoin, barbiturates, and pyrimidine, the pH of experiment medium was adjusted to 2.…”

Section: Methodsmentioning

confidence: 99%

Drug-facilitated crime caused by drinks or foods

Gharedaghi

Hassanian‐Moghaddam

Akhgari

et al. 2018

Egypt J Forensic Sci

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Background: Offenders performing drug-facilitated crime (DFC) generally choose their drug based on its availability and their own attitude. Prevalence of DFC has increased in our society triggering some public concerns. Treatment of the patients strongly depends on the abused drug while the type of the drug involved is generally unknown; hence, we performed a study to determine the most frequently abused drugs to facilitate crimes in Iran. Methods: In a prospective study, all patients who were referred to our medical toxicology ward due to DFC between February 2009 and March 2010 were included. A self-made questionnaire was filled out for each patient. Urine samples were taken on presentation, and drugs were extracted by organic solvents using liquid-liquid extraction (LLE) method. Forensic toxicology urine analyses were performed using immunochromatography and thin layer chromatography (TLC) as screening tests. High-performance liquid chromatography (HPLC) and gas chromatography/mass spectrometry (GC/MS) were used as confirmatory methods. Results: In 53 patients, 8 (15.1%) were female and the mean age was 31.6 ± 12.5 years. They were mainly poisoned to facilitate theft (77.4%). Drugs were commonly given in drinks (45.3%) and during transportations (45.4%). The patients had usually been referred with mild loss of consciousness (56.6%), and the most common drugs given were metoclopramide and dextromethorphan (18.9%). No death was documented, and the mean hospitalization period was 1 day. Conclusion: Opioids are the most commonly involved drugs in DFCs in Iran. Metoclopramide, benzodiazepines, and antihistamines are other common drugs used for this purpose. Public health education, training, and empowerment of medical staff dealing with investigating and management of DFC are required.

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“…However, our examination of patients with severe intoxication indicated that sex was unrelated to survival. The incidence of severe intoxication among different age groups also varied in previous studies (17,23,27). We found that elderly patients were more likely to die from severe intoxication.…”

Section: Discussionmentioning

confidence: 50%

Incidence of Intoxication Events and Patient Outcomes in Taiwan: a Nationwide Population-based Observational Study

Chen

Chan

Su³

2020

Preprint

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Background Intoxicated patients were frequently managed in the emergency departments (ED) with few studies at national level. The study aimed to reveal the incidence, outcomes of intoxications and trend in Taiwan.Methods Adults admitted to an ED due to an intoxication event between 2006 and 2013 were identified using the Taiwan National Health Insurance Research Database. The rate of intoxication and severe intoxication events, mortality rate, hospital length of stay (LOS), and daily medical costs of these patients were analyzed. Changes over time were analyzed using Joinpoint models. Subgroup analyses were used to assess the effect of sex, age, and presence of a prior psychiatric illness.Results A total of 20,371 ED admissions due to intoxication events were identified during the study period, and the incidence decreased with annual percentage change of 4.7% from 2006 to 2013. The mortality rate, hospital LOS, and daily medical costs were not decreased over time. Males and geriatric patients had more severe intoxication events, greater mortality rates, and greater daily medical costs. Patients with psychiatric illnesses had higher mortality rates and a longer hospital LOS, but lower daily medical expenses.Conclusion From 2006 to 2013, there was a decline in the incidence of ED admission for intoxication events in Taiwan. Males, geriatric patients, and those with psychiatric illnesses had greater risks for severe intoxication and mortality.

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Forensic toxicology analysis of self-poisoning suicidal deaths in Tehran, Iran; trends between 2011-2015

Cited by 43 publications

References 61 publications

Forensic Toxicology Perspectives of Methadone‐associated Deaths in Tehran, Iran, a 7‐year Overview

Forensic Toxicology Perspectives of Methadone‐associated Deaths in Tehran, Iran, a 7‐year Overview

Drug-facilitated crime caused by drinks or foods

Incidence of Intoxication Events and Patient Outcomes in Taiwan: a Nationwide Population-based Observational Study

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