Toxicology International (Formerly Indian Journal of Toxicology)

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Adulteration in the Drug of Abuse:An Autopsy Study on the Prevalence and its Role in Natural Death


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1 National Institute of Forensic Medicine, Hospital Kuala Lumpur, Jalan Pahang 50586, Kuala Lumpur, Malaysia
     

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Introduction: The number of natural deaths among drug abuser is increasing in number at our centre. We aim to study the prevalence of adulterants and their role in natural deaths. Methods: This was a retrospective study of all autopsy cases with positive toxicology results from the year 2014-2016 at the Forensic Medicine Department of Hospital Kuala Lumpur. Cases that died at the ward, resuscitated, decomposed and were excluded. Data for this study were retrieved from the autopsy reports which include the toxicology report. The positive toxicology cases were then categorised into morphine group, amphetamine group and methadone group. The prevalence and relatedness using statistical analysis were computed. Results and Discussion: Morphine (18.36%) was the highest prevalent drug of abuse detected from the post-mortem cases. The commonest adulterant seen in our study was chloroquine followed by paracetamol and lidocaine. A significant difference obtained in cross tabulation between respective adulterant and drug of abuse, X2 (1, N = 80) = 14.159, p < 0.05 (CI – 95%) which proves that chloroquine was preferred adulterant in all the drug groups especially in morphine group. The highest number of chloroquine was seen in cases with lung infection and perforated gastric ulcer. Lidocaine was present in the highest number in death related to the heart pathology. Conclusion: Adulterants in the drug of abuse is becoming common, with chloroquine leading the list followed by lidocaine at our centre. The effect of adulterants is not negligible. It has a role in the development of natural disease and even deaths.


Keywords

Adulterants, Drug of Abuse, Post-mortem.
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  • Adulteration in the Drug of Abuse:An Autopsy Study on the Prevalence and its Role in Natural Death

Abstract Views: 277  |  PDF Views: 5

Authors

A. H. Hasmi
National Institute of Forensic Medicine, Hospital Kuala Lumpur, Jalan Pahang 50586, Kuala Lumpur, Malaysia
P. S. Lai
National Institute of Forensic Medicine, Hospital Kuala Lumpur, Jalan Pahang 50586, Kuala Lumpur, Malaysia
M. S. Mahmood
National Institute of Forensic Medicine, Hospital Kuala Lumpur, Jalan Pahang 50586, Kuala Lumpur, Malaysia
K. Subramaniam
National Institute of Forensic Medicine, Hospital Kuala Lumpur, Jalan Pahang 50586, Kuala Lumpur, Malaysia

Abstract


Introduction: The number of natural deaths among drug abuser is increasing in number at our centre. We aim to study the prevalence of adulterants and their role in natural deaths. Methods: This was a retrospective study of all autopsy cases with positive toxicology results from the year 2014-2016 at the Forensic Medicine Department of Hospital Kuala Lumpur. Cases that died at the ward, resuscitated, decomposed and were excluded. Data for this study were retrieved from the autopsy reports which include the toxicology report. The positive toxicology cases were then categorised into morphine group, amphetamine group and methadone group. The prevalence and relatedness using statistical analysis were computed. Results and Discussion: Morphine (18.36%) was the highest prevalent drug of abuse detected from the post-mortem cases. The commonest adulterant seen in our study was chloroquine followed by paracetamol and lidocaine. A significant difference obtained in cross tabulation between respective adulterant and drug of abuse, X2 (1, N = 80) = 14.159, p < 0.05 (CI – 95%) which proves that chloroquine was preferred adulterant in all the drug groups especially in morphine group. The highest number of chloroquine was seen in cases with lung infection and perforated gastric ulcer. Lidocaine was present in the highest number in death related to the heart pathology. Conclusion: Adulterants in the drug of abuse is becoming common, with chloroquine leading the list followed by lidocaine at our centre. The effect of adulterants is not negligible. It has a role in the development of natural disease and even deaths.


Keywords


Adulterants, Drug of Abuse, Post-mortem.

References





DOI: https://doi.org/10.18311/ti%2F2018%2Fv25i2%2F21736