QUESTIONS OF DYNAMICS, FORENSIC MEDICAL AND FORENSIC CHEMICAL DIAGNOSTICS OF METHADONE POISONING IN SAINT PETERSBURG IN 2009-2018

Acute poisonings occupy one of the leading places in the structure of mortality due to external causes in the Russian Federation. In Saint Petersburg, there are consistently high rates of drug poisonings (especially methadone poisoning). Reports, statistical maps and other information of the Bureau of Forensic Medical Expertise for the period 2009 – 2018 were used for this study. The research methods were a selective copy of the data, including the results of a forensic chemical study, the calculation of statistical coefficients, descriptive. The analysis showed a decrease in mortality due to external causes in Saint Petersburg in 2009-2018, indicators (per 100 thousand of the population of Saint Petersburg) decreased gradually from 99,3 to 69,8. Acute poisoning of chemical etiology was in the 2nd place (24,9%) after mechanical injury. In the structure of acute poisoning of chemical etiology, the 1st place was occupied by fatal drug poisoning (45,1%). Their share was 28,7% in 2009-2011. It increased sharply up to 52,2% in the period 2012-2018 and began to change both qualitative and quantitative. In Saint Petersburg there were 19 fatal cases of methadone poisoning (0,04 per 100 thousand people) in 2009 and 599 cases (11,19 per 100 thousand people) in 2018. The number of forensic studies on the identification of methadone sharply increased (9 times). In almost half of the poisoning’s cases ethanol, other narcotic drugs (amphetamine derivatives, morphine, cocaine, etc.), as well as drugs and psychotropic substances (derivatives of barbituric acid, benzodiazepine, phenothiazine, etc.) were revealed along with methadone.

Forensic medical diagnostics of methadone poisoning are based on the results of chromatography-mass spectrometry, morphological features (macro- and microscopic), analysis of the clinical picture (from medical documents), and consideration of the circumstances of the poisoning. The combined reception of methadone, ethanol and other narcotic and / or psychotropic drugs has a potentiating deprimative effect, aggravates the clinical and morphological picture of poisoning, which must be taken into account when diagnosing them.