The frequency of polidrug use in a driving population in Rome

Abstract

In Italy the illicit substances routinely tested are cannabinoids, cocaine, opiates, amphetamines / methamphetamine, MDMA and similar but these substances are not the most use in our country. In particular, the consumption of ketamine represents an emerging problem. Ketamine is a anesthetic with hallucinogenic and dissociative effects and these are the ones sought for the voluptuary pur-pose, while the amnesic effect are exploited for drug facilitated sexual assault. Our study was car-ried out to assess the positivity for the illicit substances routinely tested and also for ketamine in a population of 182 patients arrived at the emergency room of the Hospital “San Camillo Forlanini” of Rome, for which have been required toxicological tests on the basis of Articles 186 and 187 of the New Highway Code.

The choice of this kind of population allows to have an accurate and reliable epidemiological data about the real diffusion of voluptuary use of drugs. The study examines 182 samples subjected to routine toxicological investigations in the period be-tween October 2011 and August 2012. The Authors have researched the presence of ethanol, cannabinoids, cocaine, opiates, amphetamines and benzodiazepines with the use of “ADVIA Chemistry Systems ”, while the ketamine is tested by a single-phase tests on urine [Sure Screen Diagnostic (Di. Ra.Lab)] with a cut-off level of this method is 1000ng/ml. During this period we have considered 182 patients (males 78%, females 22%). The mean age was 34 years (standard deviation 13, minimum 15, maximum 80). Most of the admission were during the last days of the week (Thursday 17%, Friday 15%, Saturday 15% and Sunday 17%). With re-spect to the clinical needs of subjects admitted, 42% were admitted with a red code. Considering a single substance analysis, 46 subjects resulted positive to alcohol (25%), 38 to can-nabinoids (21%), 24 to opioids (13%), 20 to cocaine (11%), 19 to benzodiapezine (10%) and 7 to ketamine (4%). Among those who resulted positive to at least one substance (95, 52% of the sample) 55 subjects re-sulted positive to one substance (58%), 27 to two substances (28%) and 13 to three or more substances (13%). Poly-use was evaluated with an indicator previously proposed by Fabi et al in 2013. This resulted in a polydrug-use score equal to 2.93 (standard deviation 1.7, minimum 1.5, maximum 9.25).