Post-Mortem Quantitation of Amphetamine in Cadaveric Fluids in Saudi Arabia

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.

Parents’ Knowledge, Attitude, and Practices toward Methamphetamine Abuse among Youth and its Risk Factors in Saudi Arabia

“…The claimed prevalence rates of substance misuse in Islamic nations are influenced by various factors. [ 10 11 12 13 14 ]…”

Heroin-Related Fatalities in Jeddah, Saudi Arabia, between 2008 and 2018

“…Moreover, the few cases may have been related to the low sample size of heroin users and the prohibition on ethanol intake by law in Saudi Arabia due to religious reasons [ 11 , 60 ]. In contrast, 28% and 13% of heroin cases showed co-ingestion of cannabinoids and amphetamine, respectively, which are more popular drugs in this region [ 25 ]; however, these drugs rarely contribute to death [ 61 , 62 , 63 ]. 6-MAM was detected in BNaF in most cases that tested positive for antemortem ethanol, which is consistent with the results of previous investigations [ 19 ].…”

Challenges and insights: Methamphetamine analysis in post-mortem putrefied human tissues in a hot climate

“…Specifically, the United Arab Emirates (50%), Bahrain (28%) have reported significant meth seizures between 2016 and 2020 ( UNODC, 2022 ). This emerging trend is noteworthy in the region, where Captagon® has traditionally been the most abused drug ( Al-Asmari, 2021 , Al-Asmari et al, 2022a , Al-Asmari et al, 2022b ). Furthermore, meth use is on the rise in Saudi Arabia (9%), mainly among amphetamine users, with a significant increase in associated fatalities.…”

“…Additional studies are urgently required to advance forensic toxicology investigations, especially in situations where neither blood nor bodily fluid specimens are accessible. While many studies have reported amphetamine and meth concentrations in various specimens ( Kalasinsky et al, 2001 , Alhazmi et al, 2020 , Al-Asmari et al, 2022a , Al-Asmari et al, 2022b ), none have explored meth concentrations in postmortem putrefied human solid tissues. Saudi Arabia, Middle East and North Africa (MENA) countries experience predominantly hot weather throughout the year, which provides conducive conditions for corpses to decompose.…”