Heroin-Related Fatalities in Jeddah, Saudi Arabia, between 2008 and 2018
To date, epidemiological studies have not evaluated heroin-related deaths in the Middle East and North African regions, especially Saudi Arabia. All heroin-related postmortem cases reported at the Jeddah Poison Control Center (JPCC) over a 10-year period (21 January 2008 to 31 July 2018) were review...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-03-01
|
| Series: | Toxics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2305-6304/11/3/248 |
| _version_ | 1797608883145932800 |
|---|---|
| author | Ahmed I. Al-Asmari Hassan Alharbi Abdulnasser E. Al-Zahrani Torki A. Zughaibi |
| author_facet | Ahmed I. Al-Asmari Hassan Alharbi Abdulnasser E. Al-Zahrani Torki A. Zughaibi |
| author_sort | Ahmed I. Al-Asmari |
| collection | DOAJ |
| description | To date, epidemiological studies have not evaluated heroin-related deaths in the Middle East and North African regions, especially Saudi Arabia. All heroin-related postmortem cases reported at the Jeddah Poison Control Center (JPCC) over a 10-year period (21 January 2008 to 31 July 2018) were reviewed. In addition, liquid chromatography electrospray ionization tandem mass spectrometry (LC/ESI-MS/MS) was utilized to determine the 6-monoacetylmorphine (6-MAM), 6-acetylcodeine (6-AC), morphine (MOR), and codeine contents in unhydrolyzed postmortem specimens. Ninety-seven heroin-related deaths were assessed in this study, and they represented 2% of the total postmortem cases at the JPCC (median age, 38; 98% male). In the blood, urine, vitreous humor, and bile samples, the median morphine concentrations were 280 ng/mL, 1400 ng/mL, 90 ng/mL, and 2200 ng/mL, respectively; 6-MAM was detected in 60%, 100%, 99%, and 59% of the samples, respectively; and 6-AC was detected in 24%, 68%, 50%, and 30% of the samples, respectively. The highest number of deaths (33% of total cases) was observed in the 21–30 age group. In addition, 61% of cases were classified as “rapid deaths,” while 24% were classified as “delayed deaths.” The majority (76%) of deaths were accidental; 7% were from suicide; 5% were from homicide; and 11% were undetermined. This is the first epidemiological study to investigate heroin-related fatalities in Saudi Arabia and the Middle East and North African region. The rate of heroin-related deaths in Jeddah remained stable but increased slightly at the end of the study period. Most patients were heroin-dependent abusers and from the middle-aged group. The availability of urine, vitreous humor, and bile specimens provided valuable information regarding the opioids that were administered and the survival time following heroin injection. |
| first_indexed | 2024-03-11T05:49:47Z |
| format | Article |
| id | doaj.art-f308a9396bb74a32a19c12478e6aeaba |
| institution | Directory Open Access Journal |
| issn | 2305-6304 |
| language | English |
| last_indexed | 2024-03-11T05:49:47Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxics |
| spelling | doaj.art-f308a9396bb74a32a19c12478e6aeaba2023-11-17T14:13:12ZengMDPI AGToxics2305-63042023-03-0111324810.3390/toxics11030248Heroin-Related Fatalities in Jeddah, Saudi Arabia, between 2008 and 2018Ahmed I. Al-Asmari0Hassan Alharbi1Abdulnasser E. Al-Zahrani2Torki A. Zughaibi3Laboratory Department, Ministry of Health, King Abdul-Aziz Hospital, Jeddah 21442, Saudi ArabiaPoison Control and Forensic Chemistry Center, Ministry of Health, Jeddah 21176, Saudi ArabiaPoison Control and Forensic Chemistry Center, Ministry of Health, Jeddah 21176, Saudi ArabiaKing Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi ArabiaTo date, epidemiological studies have not evaluated heroin-related deaths in the Middle East and North African regions, especially Saudi Arabia. All heroin-related postmortem cases reported at the Jeddah Poison Control Center (JPCC) over a 10-year period (21 January 2008 to 31 July 2018) were reviewed. In addition, liquid chromatography electrospray ionization tandem mass spectrometry (LC/ESI-MS/MS) was utilized to determine the 6-monoacetylmorphine (6-MAM), 6-acetylcodeine (6-AC), morphine (MOR), and codeine contents in unhydrolyzed postmortem specimens. Ninety-seven heroin-related deaths were assessed in this study, and they represented 2% of the total postmortem cases at the JPCC (median age, 38; 98% male). In the blood, urine, vitreous humor, and bile samples, the median morphine concentrations were 280 ng/mL, 1400 ng/mL, 90 ng/mL, and 2200 ng/mL, respectively; 6-MAM was detected in 60%, 100%, 99%, and 59% of the samples, respectively; and 6-AC was detected in 24%, 68%, 50%, and 30% of the samples, respectively. The highest number of deaths (33% of total cases) was observed in the 21–30 age group. In addition, 61% of cases were classified as “rapid deaths,” while 24% were classified as “delayed deaths.” The majority (76%) of deaths were accidental; 7% were from suicide; 5% were from homicide; and 11% were undetermined. This is the first epidemiological study to investigate heroin-related fatalities in Saudi Arabia and the Middle East and North African region. The rate of heroin-related deaths in Jeddah remained stable but increased slightly at the end of the study period. Most patients were heroin-dependent abusers and from the middle-aged group. The availability of urine, vitreous humor, and bile specimens provided valuable information regarding the opioids that were administered and the survival time following heroin injection.https://www.mdpi.com/2305-6304/11/3/248forensic toxicologyopiatesopioidsLC-MS/MSpostmortem |
| spellingShingle | Ahmed I. Al-Asmari Hassan Alharbi Abdulnasser E. Al-Zahrani Torki A. Zughaibi Heroin-Related Fatalities in Jeddah, Saudi Arabia, between 2008 and 2018 Toxics forensic toxicology opiates opioids LC-MS/MS postmortem |
| title | Heroin-Related Fatalities in Jeddah, Saudi Arabia, between 2008 and 2018 |
| title_full | Heroin-Related Fatalities in Jeddah, Saudi Arabia, between 2008 and 2018 |
| title_fullStr | Heroin-Related Fatalities in Jeddah, Saudi Arabia, between 2008 and 2018 |
| title_full_unstemmed | Heroin-Related Fatalities in Jeddah, Saudi Arabia, between 2008 and 2018 |
| title_short | Heroin-Related Fatalities in Jeddah, Saudi Arabia, between 2008 and 2018 |
| title_sort | heroin related fatalities in jeddah saudi arabia between 2008 and 2018 |
| topic | forensic toxicology opiates opioids LC-MS/MS postmortem |
| url | https://www.mdpi.com/2305-6304/11/3/248 |
| work_keys_str_mv | AT ahmedialasmari heroinrelatedfatalitiesinjeddahsaudiarabiabetween2008and2018 AT hassanalharbi heroinrelatedfatalitiesinjeddahsaudiarabiabetween2008and2018 AT abdulnasserealzahrani heroinrelatedfatalitiesinjeddahsaudiarabiabetween2008and2018 AT torkiazughaibi heroinrelatedfatalitiesinjeddahsaudiarabiabetween2008and2018 |