Abstract
Introduction: Amphetamines represent a widely abused class of drugs globally, with instances of fatalities resulting from inadvertent consumption. Notably, in the year 2008 in Iran, amphetamine emerged as the predominant substance subjected to abuse. Amphetamine induces a spectrum of physiological and psychoactive effects, including heightened arousal, euphoria, diminished fatigue, accelerated heart rate, positive mood, pupil dilation, elevated blood pressure, increased body temperature, behavioral disinhibition, reduced appetite, and heightened alertness. The autopsy and pathological findings associated with fatalities resulting from amphetamine intoxication have garnered limited scrutiny. This study endeavors to characterize and compare the autopsy and pathological findings in amphetamine intoxicated deceased.
Objectives: This study aims to investigate and compare the autopsy and pathological findings in cases of amphetamine-related fatalities. It seeks to provide insights into the toxicological, clinical, and pathological profiles of these cases in Isfahan, Iran, over a decade (2012–2022), contributing to a better understanding of the impacts of amphetamine intoxication.
Materials and Methods: We systematically identified all instances of amphetamine-related fatalities in Isfahan spanning the period from 2012 to 2022, utilizing data derived from the Noor and Ali Asghar Hospital Electronic Medical Report. Comprehensive information pertaining to demographic characteristics, clinical symptoms, autopsy, and pathology was meticulously documented in a checklist for each patient and subjected to thorough analysis.
Results: Between 2012 and 2022, a total of 42 fatalities attributable to amphetamine were identified, encompassing 32 males (76.2%) and 10 females (23.8%), with a mean age of 37.47±10.87 years. Postmortem analyses revealed frequent co-occurrence of tricyclic antidepressants and benzodiazepines in the samples. A notable 14.3% exhibited a history of underlying diseases, while 38.1% had documented psychological disorders. Methamphetamine was the predominant form of the drug, with an average dosage of 3428.7±1618.34 mg. Autopsy findings indicated pulmonary damage in 42.85%, cardiac damage in 23.8%, cerebral damage in 14.28%, hepatic damage in 28.6%, and renal damage in 9.52% of the deceased.
Conclusion: Our investigation revealed that amphetamine abuse typically culminates in swift mortality attributed to multi-organ compromise. Amphetamine induces adverse effects encompassing hepatic damage, rhabdomyolysis, pulmonary edema, cerebral edema, and cerebral hemorrhage.