Abstract

Poisoning is among the top three common causes of suicidal deaths in Iran. We aimed to evaluate the epidemiologic trend of poisoning and its mortality rate in the largest tertiary toxicology referral center in Iran between 2012 and 2018. A total of 84,242 patients were hospitalized or died due to poisoning in this center during the study period, of whom 2114 (2.5%) died. The most frequent poisonings were those with antiepileptics, sedativehypnotics, and antiparkinson medications (T42) followed by narcotics and psychodysleptics (T40). Psychodysleptics had the highest mortality rate (684; 32.4% of the deaths). Among drugs of abuse, methadone was the most common cause of admission reported in 10,398 cases (12.3%). In conclusion, suicidal or recreational methadone poisoning is becoming the most common cause of admission to poisoning referral wards in Iran. Rigorous supervision of daily dosing at opioid maintenance clinics as well as efforts to control the black-market offering methadone are needed to prevent further methadone-related acute poisonings and deaths.

摘要

中毒是伊朗自杀死亡的三​​大常见原因之一。我们旨在评估 2012 年至 2018 年间伊朗最大的三级毒理学转诊中心的中毒流行病学趋势及其死亡率。研究期间该中心共有 84,242 名患者因中毒住院或死亡，其中 2114 人(2.5%) 死亡。最常见的中毒是使用抗癫痫药、镇静催眠药和抗帕金森药物 (T42)，其次是麻醉药和精神障碍药 (T40)。精神障碍患者的死亡率最高（684 人；占死亡人数的 32.4%）。在滥用药物中，美沙酮是 10,398 例（12.3%）报告的最常见入院原因。综上所述，自杀或娱乐性美沙酮中毒正在成为伊朗中毒转诊病房最常见的入院原因。需要对阿片类药物维持诊所的日常给药进行严格监督，并努力控制黑市提供的美沙酮，以防止进一步与美沙酮相关的急性中毒和死亡。