PMID- 37933709
OWN - NLM
STAT- MEDLINE
DCOM- 20240424
LR  - 20240425
IS  - 1942-7611 (Electronic)
IS  - 1942-7603 (Linking)
VI  - 16
IP  - 6
DP  - 2024 Jun
TI  - Comparison of poisoning deaths with wastewater-based consumption estimates and 
      assessment of fatal toxicity for amphetamine-type stimulant drugs.
PG  - 641-649
LID - 10.1002/dta.3599 [doi]
AB  - Among several established indicators that are used to monitor the illicit drug 
      scene, drug-related deaths and wastewater-based epidemiology (WBE) stand out for 
      population-level coverage. In this study, we aimed to compare temporal trends 
      with respect to amphetamine, methamphetamine and methylenedioxymethamphetamine 
      (MDMA) revealed by these indicators and explore the differences in fatal toxicity 
      between the stimulants. All deaths in which poisoning caused by amphetamine, 
      methamphetamine or MDMA was either the underlying or contributing cause of death 
      in Finland in 2012, 2014, 2016, 2018 and 2020 were included in the study. 
      Consumption of the studied drugs was measured by WBE in the same years. There was 
      a significant correlation between poisoning and drug consumption for all three 
      stimulants, and for amphetamine and MDMA, these figures increased over the study 
      period. The highest fatal toxicity, as expressed by the number of deaths per 
      million doses, was obtained for methamphetamine at an estimated dose of 50 mg, 
      followed by MDMA (100 mg dose) and with amphetamine (50 mg dose). The fatal 
      toxicity found here for the stimulants was close to that previously reported for 
      many prescription opioids and tricyclic antidepressants. Our study is the first 
      to quantitatively investigate the fatal toxicity of amphetamine-type stimulants 
      by comparing deaths with consumption estimates derived from WBE. It shows that 
      amphetamine, methamphetamine and MDMA possess a quite similar capacity to cause 
      death. This new approach adds to the earlier methods of estimating drug-related 
      harm.
CI  - (c) 2023 The Authors. Drug Testing and Analysis published by John Wiley & Sons Ltd.
FAU - Kriikku, Pirkko
AU  - Kriikku P
AUID- ORCID: 0000-0002-5721-2827
AD  - Forensic Chemistry Unit, Finnish Institute for Health and Welfare, Helsinki, 
      Finland.
AD  - Department of Forensic Medicine, University of Helsinki, Helsinki, Finland.
FAU - Kankaanpaa, Aino
AU  - Kankaanpaa A
AD  - Forensic Chemistry Unit, Finnish Institute for Health and Welfare, Helsinki, 
      Finland.
FAU - Gunnar, Teemu
AU  - Gunnar T
AD  - Forensic Chemistry Unit, Finnish Institute for Health and Welfare, Helsinki, 
      Finland.
FAU - Ojanpera, Ilkka
AU  - Ojanpera I
AUID- ORCID: 0000-0001-5790-1473
AD  - Forensic Chemistry Unit, Finnish Institute for Health and Welfare, Helsinki, 
      Finland.
AD  - Department of Forensic Medicine, University of Helsinki, Helsinki, Finland.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20231107
PL  - England
TA  - Drug Test Anal
JT  - Drug testing and analysis
JID - 101483449
RN  - 44RAL3456C (Methamphetamine)
RN  - 0 (Wastewater)
RN  - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine)
RN  - CK833KGX7E (Amphetamine)
RN  - 0 (Central Nervous System Stimulants)
RN  - 0 (Illicit Drugs)
RN  - 0 (Amphetamines)
SB  - IM
MH  - Humans
MH  - *Methamphetamine/poisoning/toxicity
MH  - Finland/epidemiology
MH  - *Wastewater
MH  - *N-Methyl-3,4-methylenedioxyamphetamine
MH  - *Amphetamine/analysis
MH  - *Central Nervous System Stimulants/poisoning
MH  - *Illicit Drugs
MH  - Substance Abuse Detection/methods
MH  - Amphetamines
MH  - Adult
MH  - Wastewater-Based Epidemiological Monitoring
MH  - Male
OTO - NOTNLM
OT  - MDMA
OT  - amphetamines
OT  - drug-related death
OT  - fatal toxicity
OT  - wastewater-based epidemiology
EDAT- 2023/11/07 12:43
MHDA- 2024/04/24 19:05
CRDT- 2023/11/07 06:43
PHST- 2023/10/19 00:00 [revised]
PHST- 2023/07/18 00:00 [received]
PHST- 2023/10/21 00:00 [accepted]
PHST- 2024/04/24 19:05 [medline]
PHST- 2023/11/07 12:43 [pubmed]
PHST- 2023/11/07 06:43 [entrez]
AID - 10.1002/dta.3599 [doi]
PST - ppublish
SO  - Drug Test Anal. 2024 Jun;16(6):641-649. doi: 10.1002/dta.3599. Epub 2023 Nov 7.