Abstract:
Xylazine sedative, muscle relaxant, and analgesic used in a veterinary setting. Although xylazine was never approved for therapeutic use in humans, it has become popular in the street drug market as a cutting or bulking agent in the fentanyl and heroin supply. Recently, there has been a significant increase in the detection of xylazine in postmortem forensic toxicology casework. Xylazine can be identified during routine toxicology screening utilizing instrumentation such as gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry. Using the Miami-Dade Medical Examiner\'s LIMS system, all cases received between 2015 and 2022 in which xylazine was reported were reviewed. The cases studied include accidental drug overdose deaths in Miami-Dade County as well as Collier County (Naples), Florida. In total, there are 170 cases; the majority are accidental polydrug overdoses involving White males between the ages of 25 and 44 years old. Of the 170 cases, 37% listed xylazine as the cause of death. 13% of cases contained only xylazine and fentanyl while the remaining 87% of deaths were attributed to polydrug toxicity involving two or more substances. The prevalence of xylazine can be attributed to its increasing popularity rather than an increase in caseload. In 2019, xylazine was present in only 4% of all accidental fentanyl overdoses. By 2021, this percentage has increased sixfold, with xylazine present in 24% of all accidental fentanyl overdoses. Despite a decrease in fentanyl overdoses in 2022, the percentage of xylazine detection remained the same.
摘要:
赛拉嗪镇静剂,肌肉松弛剂,和在兽医环境中使用的镇痛药。尽管赛拉嗪从未被批准用于人类治疗,它作为芬太尼和海洛因供应的切割或膨胀剂,在街头毒品市场上很受欢迎。最近,在死后法医毒理学案件中,赛拉嗪的检测显着增加。在常规毒理学筛选过程中,可以使用诸如气相色谱-质谱和液相色谱-质谱的仪器来鉴定赛拉嗪。使用迈阿密戴德体检医师的LIMS系统,我们对2015年至2022年间收到的所有报告赛拉嗪的病例进行了回顾.研究的病例包括迈阿密戴德县和科利尔县(那不勒斯)的意外药物过量死亡,佛罗里达总的来说,有170例;大多数是意外的多药过量,涉及年龄在25至44岁之间的白人男性。在170个案例中,37%将赛拉嗪列为死亡原因。13%的病例仅含有赛拉嗪和芬太尼,而其余87%的死亡归因于涉及两种或多种物质的多药物毒性。赛拉嗪的流行可归因于其日益普及,而不是病例数的增加。2019年,赛拉嗪仅占所有意外芬太尼过量的4%。到2021年,这一比例增加了六倍,24%的意外芬太尼过量服用赛拉嗪。尽管2022年芬太尼过量减少,但赛拉嗪检测的百分比保持不变。