Anna Koski1, Ilkka Ojanperä, Erkki Vuori. 1. Laboratory of Toxicology, Department of Forensic Medicine, University of Helsinki, Finland. anna.koski@iki.fi
Abstract
BACKGROUND: Postmortem forensic toxicology frequently finds alcohol both alone and in combination with drugs. Although benzodiazepines are generally considered safe, they are considered dangerous with alcohol. METHODS: A retrospective statistical analysis of alcohol and benzodiazepine concentrations in postmortem blood samples included 808 cases diagnosed as fatal alcohol or drug intoxication involving (1) ethanol alone; (2) ethanol with temazepam; or (3) ethanol with any combination of diazepam, chlordiazepoxide, and nordazepam. RESULTS: The median concentration of ethanol was 3.3 per thousand in cases with ethanol alone and 3.5 per thousand when diazepam was present, but it was significantly lower, only 2.5 per thousand, when temazepam was present in the blood. Furthermore, the median concentration of ethanol was 2.2 per thousand in cases with high concentrations (>0.9 mg/liter) of temazepam and 2.7 per thousand in cases with therapeutic (< or =0.9 mg/liter) concentrations. CONCLUSIONS: Diazepam and chlordiazepoxide pose a smaller risk of death by poisoning than does temazepam when given as a hypnotic to patients suffering from alcoholism.
BACKGROUND: Postmortem forensic toxicology frequently finds alcohol both alone and in combination with drugs. Although benzodiazepines are generally considered safe, they are considered dangerous with alcohol. METHODS: A retrospective statistical analysis of alcohol and benzodiazepine concentrations in postmortem blood samples included 808 cases diagnosed as fatal alcohol or drug intoxication involving (1) ethanol alone; (2) ethanol with temazepam; or (3) ethanol with any combination of diazepam, chlordiazepoxide, and nordazepam. RESULTS: The median concentration of ethanol was 3.3 per thousand in cases with ethanol alone and 3.5 per thousand when diazepam was present, but it was significantly lower, only 2.5 per thousand, when temazepam was present in the blood. Furthermore, the median concentration of ethanol was 2.2 per thousand in cases with high concentrations (>0.9 mg/liter) of temazepam and 2.7 per thousand in cases with therapeutic (< or =0.9 mg/liter) concentrations. CONCLUSIONS:Diazepam and chlordiazepoxide pose a smaller risk of death by poisoning than does temazepam when given as a hypnotic to patients suffering from alcoholism.
Authors: Kelly P Cosgrove; Irina Esterlis; Graeme F Mason; Frederic Bois; Stephanie S O'Malley; John H Krystal Journal: Neuropharmacology Date: 2011-01-27 Impact factor: 5.250
Authors: Daya I Perkins; James R Trudell; Daniel K Crawford; Liana Asatryan; Ronald L Alkana; Daryl L Davies Journal: J Biol Chem Date: 2009-08-05 Impact factor: 5.157
Authors: Michael P Bogenschutz; Snehal Bhatt; Juliane Bohan; Bellelizabeth Foster; Paul Romo; Claire E Wilcox; J Scott Tonigan Journal: Am J Drug Alcohol Abuse Date: 2016-05-16 Impact factor: 3.829