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https://www.readbyqxmd.com/read/28425102/fatal-overdose-of-gamma-hydroxybutyrate-acid-after-ingestion-of-1-4-butanediol
#1
Erwan Le Garff, Vadim Mesli, Raphael Cornez, Christophe Demarly, Gilles Tournel, Valery Hédouin
We report a case of fatal intoxication from 1,4-butanediol (1,4-BD), which was ingested by a young and "naïve" gamma-hydroxybutyrate (GHB) consumer during a party with the co-ingestion of alcohol, cannabis, and methylene-dioxy-methamphetamine. The following drug concentrations were found using gas chromatography coupled with mass spectrometry on autopsy samples and on a cup and a glass found at the scene: 20,350 mg/L (bottle) for 1,4-BD; 1020 mg/L (femoral blood), 3380 mg/L (cardiac blood), 47,280 mg/L (gastric content), and 570 mg/L (vitreous humor) for GHB...
April 20, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28406883/characteristics-of-fentanyl-overdose-massachusetts-2014-2016
#2
Nicholas J Somerville, Julie O'Donnell, R Matthew Gladden, Jon E Zibbell, Traci C Green, Morgan Younkin, Sarah Ruiz, Hermik Babakhanlou-Chase, Miranda Chan, Barry P Callis, Janet Kuramoto-Crawford, Henry M Nields, Alexander Y Walley
Opioid overdose deaths in Massachusetts increased 150% from 2012 to 2015 (1). The proportion of opioid overdose deaths in the state involving fentanyl, a synthetic, short-acting opioid with 50-100 times the potency of morphine, increased from 32% during 2013-2014 to 74% in the first half of 2016 (1-3). In April 2015, the Drug Enforcement Agency (DEA) and CDC reported an increase in law enforcement fentanyl seizures in Massachusetts, much of which was believed to be illicitly manufactured fentanyl (IMF) (4)...
April 14, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28405999/near-fatal-poisoning-by-isoniazid-and-rifampicin
#3
Arun Agarwal, Samiksha Sharma, Ritu Bansal, Meghraj Meena, Mala Airun
Since six decades, Isoniazid and Rifampicin are used as first line drugs for treatment of tuberculosis. The minimum acute lethal or toxic dose of Rifampicin is not well established. However, non-fatal acute overdoses in adults have been reported with doses ranging from 9 to 12 gm and fatal acute overdoses with doses ranging from 14 to 60 gm. Isoniazid, if acutely ingested, even 1.5 to 2 gram may cause toxicity in adults. We report a case of Pott's spine on ATT, who took massive overdose of Rifampicin (>18 gm) and Isoniazid (>12 gm) and reported late (almost 36 hours) after ingestion...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28358791/methadone-prescribing-and-overdose-and-the-association-with-medicaid-preferred-drug-list-policies-united-states-2007-2014
#4
Mark Faul, Michele Bohm, Caleb Alexander
Drug overdose is a leading cause of injury death in the United States; 47,055 fatal drug overdoses were reported in 2014, a 6.5% increase from the previous year (1), driven by opioid use disorder (2,3). Methadone is an opioid prescribed for pain management and is also provided through opioid treatment programs to treat opioid use disorders. Because methadone might remain in a person's system long after the pain-relieving benefits have been exhausted, it can cause slow or shallow breathing and dangerous changes in heartbeat that might not be perceived by the patient (4,5)...
March 31, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28349617/exploring-synthetic-heroin-accounts-of-acetyl-fentanyl-use-from-a-sample-of-dually-diagnosed-drug-offenders
#5
J Mitchell Miller, John M Stogner, Bryan Lee Miller, Scott Blough
INTRODUCTION AND AIMS: Acetyl fentanyl, a fentanyl analogue emerging onto the recreational drug scene, has been responsible for numerous recent fatal overdoses in the USA, Europe and Russia. Studies reporting acetyl fentanyl use are presently limited to case studies and mortality reports. This study explores the nature of acetyl fentanyl use through the collection of first-hand qualitative data from users to inform public health and drug control policy responses. DESIGN AND METHODS: A series of focus group interviews within a correctional setting-Delaware County (Ohio) Jail, USA...
March 28, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28334840/review-of-caffeine-related-fatalities-along-with-postmortem-blood-concentrations-in-51-poisoning-deaths
#6
Alan Wayne Jones
Publications reporting concentrations of caffeine in postmortem blood were reviewed if the cause of death was attributed to overdosing (poisoning) with drugs. Age and gender of the deceased, the manner of death (accident, suicide or undetermined) and types of co-ingested drugs were evaluated in relation to the concentrations of caffeine in blood (N = 51). The mean age (±SD) of the victims was 39 ± 17.8 years (range 18-84 years) and most were female (N = 31 or 61%). The difference in mean age of males (42 ± 17...
April 1, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28329723/analysis-of-synthetic-phenethylamine-street-drugs-using-direct-sample-analysis-coupled-to-accurate-mass-time-of-flight-mass-spectrometry
#7
Maura K McGonigal, Joshua A Wilhide, Philip B Smith, Noelle M Elliott, Frank L Dorman
Serious health complications and fatal overdoses have brought phenethylamine, otherwise known as 2C, drug abuse to the public's attention. These compounds are 2C-X series analogs of mescaline. The name "2C" results from the two carbons in the ethyl chain. The substituents on these emerging drugs are constantly changed in order to avoid listing as controlled substances. These synthetic drugs are marketed as having affects similar to LSD and MDMA and are typically consumed sublingually via blotter paper. Twenty-six commercially available standards were analyzed using a direct sample analysis technique coupled to accurate mass time of flight mass spectrometry...
March 8, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28253466/self-poisoning-by-older-australians-a-cohort-study
#8
Peter I Pillans, Colin B Page, Sivarajah Ilango, Anna Kashchuk, Geoffrey K Isbister
OBJECTIVE: To examine the epidemiology and severity of self-poisoning by older people in Australia; to compare these data with those for overdoses in younger adults. DESIGN, SETTING, PARTICIPANTS: A cohort study of people presenting to a tertiary toxicology centre after self-poisoning over 26 years (1987-2012). MAIN OUTCOME MEASURES: Hospital length of stay (LOS); types of drug ingested; intensive care unit (ICU) admissions; in-hospital deaths...
March 6, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28160345/does-exposure-to-opioid-substitution-treatment-in-prison-reduce-the-risk-of-death-after-release-a-national-prospective-observational-study-in-england
#9
John Marsden, Garry Stillwell, Hayley Jones, Alisha Cooper, Brian Eastwood, Michael Farrell, Tim Lowden, Nino Maddalena, Chris Metcalfe, Jenny Shaw, Matthew Hickman
BACKGROUND AND AIMS: People with opioid use disorder (OUD) in prison face an acute risk of death after release. We estimated whether prison-based opioid substitution treatment (OST) reduces this risk. DESIGN: Prospective observational cohort study using prison healthcare, national community drug misuse treatment and deaths registers. SETTING: Recruitment at 39 adult prisons in England (32 male; 7 female) accounting for 95% of OST treatment in England during study planning...
February 4, 2017: Addiction
https://www.readbyqxmd.com/read/28152635/self-poisoning-with-baclofen-in-alcohol-dependent-patients-national-reports-to-french-poison-control-centers-2008-2013
#10
MULTICENTER STUDY
Fanny Pelissier, Luc de Haro, Florence Cardona, Cyndie Picot, Emmanuel Puskarczyk, Jean-Marc Sapori, Christine Tournoud, Nicolas Franchitto
BACKGROUND: Alcohol use disorders are frequently associated with self-intoxication in attempted suicide. In France since 2008, the off-label use of baclofen for treatment of alcohol dependence has greatly increased, leading to temporary regulation of use of the drug. At the request of the national authorities, the French Poison Control Centers carried out a retrospective survey to give an overview of baclofen exposure in this population. METHODS: A retrospective study was carried out from January 2008 to December 2013, focusing on baclofen exposures in alcohol-dependent patients managed by the nine national French Poison Control Centers...
April 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28135844/morbidity-and-mortality-associated-with-medications-used-in-the-treatment-of-depression-an-analysis-of-cases-reported-to-u-s-poison-control-centers-2000-2014
#11
J Craig Nelson, Daniel A Spyker
OBJECTIVE: The authors sought to determine the relative morbidity and mortality associated with drugs used to treat depression and to examine specific clinical effects associated with serious outcomes. METHOD: The National Poison Data System, which receives exposure reports from regional poison centers serving the United States, Puerto Rico, and the District of Columbia, was queried for single drug exposures in individuals 12 years and older during the period 2000-2014...
January 31, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/28127666/examining-fatal-opioid-overdoses-in-marion-county-indiana
#12
Bradley Ray, Kenna Quinet, Timothy Dickinson, Dennis P Watson, Alfarena Ballew
Drug-related overdoses are now the leading injury-related death in the USA, and many of these deaths are associated with illicit opioids and prescription opiate pain medication. This study uses multiple sources of data to examine accidental opioid overdoses across 6 years, 2010 through 2015, in Marion County, IN, an urban jurisdiction in the USA. The primary sources of data are toxicology reports from the county coroner, which reveal that during this period, the most commonly detected opioid substance was heroin...
January 26, 2017: Journal of Urban Health: Bulletin of the New York Academy of Medicine
https://www.readbyqxmd.com/read/28036135/circumstances-surrounding-non-fatal-opioid-overdoses-attended-by-ambulance-services
#13
Desiree Madah-Amiri, Thomas Clausen, Lars Myrmel, Guttorm Brattebø, Philipp Lobmaier
INTRODUCTION AND AIMS: Opioid overdose fatalities are a significant concern globally. Non-fatal overdoses have been described as a strong predictor for future overdoses, and are often attended by the ambulance services. This paper explores characteristics associated with non-fatal overdoses and aims to identify possible trends among these events in an urban area in Norway. DESIGN AND METHODS: This is a retrospective analysis of non-fatal overdoses from Bergen ambulance services from 2012 to 2013...
December 30, 2016: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28009694/can-emergency-department-hospital-discharge-and-death-data-be-used-to-monitor-burden-of-drug-overdose-in-rhode-island
#14
Yongwen Jiang, James V McDonald, Jennifer Koziol, Meghan McCormick, Samara Viner-Brown, Nicole Alexander-Scott
CONTEXT: Drug overdoses are a growing public health problem in the United States. Rhode Island is also confronted with a serious epidemic of drug overdose deaths and ranks sixth worst in the United States for age-adjusted drug overdose death rate. OBJECTIVE: To monitor trends of drug overdose-related emergency department (ED) visits, hospitalizations, and deaths and classify the drug overdoses by demographics, discharge status, intent, and specific drug involved to plan for health care resource allocation, mental health services, drug abuse treatment, prevention, and policies...
December 22, 2016: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/27992785/identification-of-novel-psychoactive-substances-25b-nbome-and-4-cmc-in-biological-material-using-hplc-q-tof-ms-and-their-quantification-in-blood-using-uplc-ms-ms-in-case-of-severe-intoxications
#15
Marek Wiergowski, Justyna Aszyk, Michał Kaliszan, Kamila Wilczewska, Jacek Sein Anand, Agata Kot-Wasik, Zbigniew Jankowski
This paper describes cases of poisoning caused by new psychoactive substances such as: 25B-NBOMe (2-(4-bromo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine) and 4-CMC (1-(4-chlorophenyl)-2-(methylamino)-1-propanone). The analytical procedure includes rapid and selective method for the extraction and determination of 4-CMC and 25B-NBOMe in blood samples using UPLC-MS/MS technique. To the best of our knowledge, this is the first report, that involves a fully validated method for quantification of new-designer drug - 4-CMC in postmortem blood samples...
January 15, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/27976363/acute-skin-and-hair-symptoms-followed-by-severe-delayed-eye-complications-in-subjects-using-the-synthetic-opioid-mt-45
#16
A Helander, M Bradley, A Hasselblad, L Norlén, I Vassilaki, M Bäckberg, J Lapins
BACKGROUND: The introduction of unclassified new psychoactive substances (NPS) on the recreational drugs market through open online sale ('legal highs' or 'Internet drugs') continues unabated and represents a growing health hazard. The use of NPS has resulted in numerous, severe, adverse events and fatalities, due to unintended overdose or unknown toxic side-effects. OBJECTIVES: To try to find a possible common underlying cause for the skin-hair-eye symptoms complex observed in three men...
December 14, 2016: British Journal of Dermatology
https://www.readbyqxmd.com/read/27917016/the-portapotty-experiment-neoliberal-approaches-to-the-intertwined-epidemics-of-opioid-related-overdose-and-hiv-hcv-and-why-we-need-cultural-anthropologists-in-the-south-bronx
#17
Brett Wolfson-Stofko, Ric Curtis, Faustino Fuentes, Ed Manchess, Alexis Del Rio-Cumba, Alex S Bennett
The following report from the field focuses on the authors' collective efforts to operate an ad hoc safer injection facility (SIF) out of portapotties (portable toilets) in an area of the South Bronx that has consistently experienced some of the highest overdose morbidity and mortality rates in New York City over the past decade (New York City Department of Health and Mental Hygiene, 2011, 2015, 2016). Safer injection facilities (also known as supervised injection facilities, drug consumption rooms, etc.) operating outside the US provide a legal, hygienic, and supervised environment for individuals to use drugs in order to minimize the likelihood of fatal overdose and the spread of blood-borne infections while reducing public injection...
December 2016: Dialectical Anthropology
https://www.readbyqxmd.com/read/27907848/fatal-and-non-fatal-overdose-after-narcology-hospital-discharge-among-russians-living-with-hiv-aids-who-inject-drugs
#18
Alexander Y Walley, Debbie M Cheng, Emily K Quinn, Elena Blokhina, Natalia Gnatienko, Christine E Chaisson, Evgeny Krupitsky, Philip O Coffin, Jeffrey H Samet
OBJECTIVES: Among Russians living with HIV/AIDS who inject drugs, we examined the incidence of fatal and non-fatal overdoses following discharge from a narcology hospital and the associations with more advanced HIV infection. DESIGN: Prospective cohort study of data collected at baseline, 3 and 6 months from HIV-infected patients with a history of injection drug use who were not treated with anti-retroviral therapy. Participants were recruited between 2012-2014 from a narcology (addiction) hospital in St...
January 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/27830905/-drug-safety-associated-with-the-change-of-digitalis-drug-in-norway
#19
Christian Haga, Mimi Stokke Opdal, Silja Skogstad Tuv, Per Henrik Zahl, Hanne Stenberg-Nilsen
BACKGROUND In 2011, following a period with delivery problems, the only registered digitoxin drug in Norway was replaced with digoxin. As a result, approximately 21 000 patients had to replace digitoxin with digoxin. There are important pharmacokinetic differences between digitoxin and digoxin (the general term for both drugs is digitalis), which must be taken into account when changing therapy. The aim of this study was to investigate compliance of drug security, during the transition from digitoxin to digoxin in Norway...
November 2016: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://www.readbyqxmd.com/read/27784226/evidence-of-2-populations-of-mephedrone-abusers-by-hair-testing-application-to-4-forensic-expertises
#20
Pascal Kintz
New psychoactive substances are conquering the drug scene. Among these substances, cathinone derivatives have been observed since late in the year 2000. At that time, an increasing use of the synthetic cathinone mephedrone (4-methylmethcathinone) started to be observed, particularly among night clubbers. Although these new psychoactive drugs showed an appearance of safety, a growing amount of experiences on their secondary effects has been reported. Mephedrone for example is known to induce psychosis. Given the potential negative effects of mephedrone, the laboratory was asked to test for the drug in hair, a cumulative matrix that can document single, occasional or repetitive abuse of xenobiotics...
October 26, 2016: Current Neuropharmacology
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