title: Methamphetamine-related fatalities in forensic autopsy during 5 years in the southern half of Osaka city and surrounding areas.
abstract: To outline the recent features of methamphetamine-related fatalities from the medico-legal point of view, a retrospective investigation of forensic autopsy cases involving methamphetamine during a 5-year period (1994-1998) in the southern half of Osaka city and surrounding areas (about 1.57 million population) was undertaken. Among 646 autopsy cases, methamphetamine was detected in 15 victims (nine males, six females; 16-71 years of age; most frequently in males in their thirties). Primary scenes of fatal events were concentrated in the middle of the city. About half of them were transferred from emergency medical centers (survival time, up to 30 h). The cause and manner of death were: methamphetamine poisoning (n=4), homicide (n=4), accidental falls and aspiration from drug abuse (n=4), fire death (n=1), myocardial infarction (n=1), and cerebral hemorrhage (n=1) under drug influence. Usually injection scars and fresh puncture sites were found. Blood methamphetamine concentrations were 2.29-17.05 micromol/dl in the fatal poisoning, 0. 44-3.80 micromol/dl in deaths from other extrinsic causes (trauma), and 1.35-2.17 micromol/dl in cardio- and cerebrovascular strokes. Common complications were cardiomyopathy, cerebral perivasculitis and liver cirrhosis/interstitial hepatitis. Fatal and nonfatal methamphetamine poisonings are separately dealt with by the administrative medical examiner's office and in emergency medical centers. Tightly cooperative approaches of clinical and medico-legal experts are required for the effective social and medical management of drug abuse.
authors.affiliation: Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585, Osaka, Japan. baolizhu@med.osaka-cu.ac.jp
authors.forename: B L
authors.initials: BL
authors.lastname: Zhu
authors.forename: S
authors.initials: S
authors.lastname: Oritani
authors.forename: K
authors.initials: K
authors.lastname: Shimotouge
authors.forename: K
authors.initials: K
authors.lastname: Ishida
authors.forename: L
authors.initials: L
authors.lastname: Quan
authors.forename: M Q
authors.initials: MQ
authors.lastname: Fujita
authors.forename: M
authors.initials: M
authors.lastname: Ogawa
authors.forename: H
authors.initials: H
authors.lastname: Maeda
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001344:Autopsy / Q000706:statistics & numerical data*; D002423:Cause of Death; D000697:Central Nervous System Stimulants / Q000506:poisoning*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008694:Methamphetamine / Q000506:poisoning*; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D017678:Sex Distribution; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control; D014505:Urban Population / Q000706:statistics & numerical data* / Q000639:trends
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine