Involvement of Amphetamines in Sudden and Unexpected Death

Authors

  • Jennifer L. Pilgrim B.Sc.(Hons.),

    1. Victorian Institute of Forensic Medicine, Department of Forensic Medicine, Monash University, 57-83 Kavanagh Street, Southbank 3006, Vic., Australia.
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  • Dimitri Gerostamoulos Ph.D.,

    1. Victorian Institute of Forensic Medicine, Department of Forensic Medicine, Monash University, 57-83 Kavanagh Street, Southbank 3006, Vic., Australia.
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  • Olaf H. Drummer Ph.D.,

    1. Victorian Institute of Forensic Medicine, Department of Forensic Medicine, Monash University, 57-83 Kavanagh Street, Southbank 3006, Vic., Australia.
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  • Marc Bollmann M.D.

    1. Institut Universitaire de Médecine Légale, University Hospital Center and University of Lausanne, Bugnon 21, 1005 Lausanne, Switzerland.
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Additional information and reprint requests:
Olaf H. Drummer, Ph.D.
Professor
Victorian Institute of Forensic Medicine
Department of Forensic Medicine
Monash University
57-83 Kavanagh Street
Southbank 3006, Vic.
Australia
E-mail: olaf@vifm.org

Abstract

Abstract:  In the present study, the effects of amphetamine-class drugs were examined in cases reported to the Victorian coroner from 2001 to 2005 to determine if death can occur from the use of amphetamine-class drugs alone. A total of 169 cases were reviewed where a forensic autopsy detected amphetamine(s) in the blood. Pathology, toxicology, and police reports were analyzed in all cases to ascertain the involvement of amphetamine-class drugs in these deaths. In Victoria, methamphetamine (MA) is the principal abused amphetamine-class followed by methylenedioxymethamphetamine (MDMA). There were six cases in which a cerebral hemorrhage caused death and three cases in which serotonin syndrome was established as being caused by the interaction of MDMA and moclobemide. There were 19 cases in which long-term use of amphetamines was associated with heart disease. There were three cases where amphetamine-class drugs alone were regarded as the cause of death, of which two cases exhibited high levels of MDMA and lesser amounts of MA and/or amphetamine. There were no cases in which significant natural disease was absent and death was regarded as caused by the use of MA. There was no correlation between blood concentration of drug and outcome.

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