Abstract
Amphetamine abuse is a known problem in Saudi Arabia; it is estimated that 40% of drug abusers misuse amphetamines. Here, our aim was to perform an up-to-date epidemiological study of amphetamine-related postmortem cases in Jeddah, Saudi Arabia, in which 235 postmortem cases were included. The largest number of cases was recorded for the groups aged between 31 and 40 years (86 cases) and the lowest number of cases was recorded for the group aged between 61 and 70 years old (5 cases). Amphetamine was co-ingested with other drug(s) in 55% of the total cases (blood with sodium fluoride (BN), median, 0.3 mg/L). Approximately 23% of all deaths were due to other co-ingested drugs (BN, median, 0.2 mg/L). Amphetamines alone were detected in 107 cases, (BN, median, 0.5 mg/L). Amphetamine was the sole cause of death in 16% of the studied cases (BN, median, 1.0 mg/L). The combination of amphetamine and a pre-existing disease were observed in 9.4% of all deaths (BN, median, 0.7 mg/L). The causes of death were determined to be accidental in the majority (47%) of cases, homicides in 26% of cases, suicides in 11% of cases, and unknown in 7% of cases. This is the first discussion of the amphetamine concentration in bile in amphetamine-related deaths, the relationship between amphetamine concentration in different bodily fluids, and the amphetamine concentration in putrefied corpses. This study concluded that amphetamine abuse in Jeddah, Saudi Arabia, increased over 400% between 2012 and 2018, and 41% of these cases involved violence. This result also suggests that preventive programs targeting youth and adolescent students are required to keep schools and universities free from drugs, especially amphetamines.
Highlights
Amphetamines are considered to be among the oldest stimulant drugs, first used in the early 1900s [1,2] and still consistently abused globally [3]
We present new information regarding the distribution of amphetamines in amphetaminerelated postmortem cases using an approach that considers multiple bodily fluids analysis (blood with sodium fluoride as a preservative (BN), urine, vitreous humor, bile, and stomach contents) and comparing these data with those obtained in previously reported studies
We conclude that amphetamine-related postmortem cases in Jeddah, Saudi Arabia, increased more than 400% over the seven-year study period
Summary
Amphetamines are considered to be among the oldest stimulant drugs, first used in the early 1900s [1,2] and still consistently abused globally [3]. Regular users of amphetamines are more likely to die from several causes [1]. Amphetamine abuse is a problem in Saudi Arabia, with 40% of drug abusers estimated to use amphetamines, young individuals (12–22 years old) [5,6]. More than two-thirds of global amphetamine seizures are reported in Saudi Arabia [7,8]. It is not known when amphetamine use started in Saudi Arabia, but it has been banned since 1986 [9]. High rates of amphetamine abuse in this region can be explained by the general idea among users that amphetamine is a harmless and recreational drug that do not often result in fatality [10]. Some students believe that amphetamine use can help them overcome sleep deprivation and fatigue; amphetamines weaken cognition and can cause many serious complications [11]
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