An alarming rise in the prevalence of deaths with methamphetamine involved in Tehran, Iran 2011-2018
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ORIGINAL ARTICLE
An alarming rise in the prevalence of deaths with methamphetamine involved in Tehran, Iran 2011‑2018 Somayeh Paknahad1 · Maryam Akhgari2 · Masoud Ghadipasha2 Accepted: 4 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Methamphetamine is one of the most commonly abused illicit drugs in Iran. Despite this fact, there has been relatively little research on methamphetamine-associated deaths in Iran. The present study aimed to investigate the cause of death in methamphetamine positive cases based on forensic toxicology findingsIn this data base descriptive study, individuals with methamphetamine-associated deaths that were referred to the Legal Medicine Organization, Tehran, Iran (2011-2018) were assessed. Deaths including those from natural causes, toxicity, accident and suicides with positive forensic toxicology analyses for methamphetamine and its metabolite amphetamine in postmortem samples were investigated. All cases were examined to determine trends in methamphetamine-associated deaths, and in the manner and causes of deaths.During the eight year study there were 1389 methamphetamine-associated deaths. The mean age was 37.47±10.87 years, with a male/ female ratio of 12.36:10. The methamphetamine-associated death rate increased significantly during the study period (2.05 vs. 21.93 per 1 06 Tehran province populations). The most common cause of death was cardiac arrest due to stimulant abuse with supportive histologic findings of acute myocardial infarction, myocardial fiber hypertrophy, aortic dissection and perivascular fibrosis (25%). Opioids (methadone, tramadol and morphine), tricyclic antidepressants and benzodiazepines were frequently present in postmortem samples of study cases.Methamphetamine-associated deaths significantly contribute to illicit drug-associated deaths in Tehran and represent a substantial clinical and public health problem. Keywords Cause of death · Drug abuse · Forensic toxicology · Illicit drugs · Methamphetamine
Introduction Methamphetamine abuse and its related health issues are a global health concern, becoming as a new serious and complex problem in Iranian society [1]. Previous study in Iran proved that methamphetamine dependence was significantly associated with social dysfunction, high rates of depression, more engagement in high risk and violent behaviors, psychosis, hospitalization and suicidal ideation [1]. Methamphetamine, colloquially known as Shisheh and Crystal first appeared in Iran in 2005, originating and being imported to Iran from south-east Asia [2]. Methamphetamine is now * Maryam Akhgari [email protected] 1
Department of Toxicology & Pharmacology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
Forensic Toxicology Department, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
2
the most popular and available amphetamine type stimulant in Iran, which has been the case since 2008 [3]. Before that time, opioids such
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