Comparison of acute lethal toxicity of commonly abused psychoactive substances

Addiction
Robert S Gable

Abstract

To determine the acute lethal toxicity of a range of psychoactive substances in terms of the dose customarily used as a single substance for non-medical purposes. A structured English-language literature search was conducted to identify experimental studies and clinical reports that documented human and non-human lethal doses of 20 abused substances that are distributed widely in Europe and North America. Four inclusion criteria were specified for the reports, and approximately 3000 relevant records were retrieved from search engines at Biosis, Science Citation Index, Google and the National Library of Medicine's Gateway. In order to account for different drug potencies, a 'safety ratio' was computed for each substance by comparing its reported acute lethal dose with the dose most commonly used for non-medical purposes. The majority of published reports of acute lethal toxicity indicate that the decedent used a co-intoxicant (most often alcohol). The calculated safety ratios varied between substances by more than a factor of 100. Intravenous heroin appeared to have the greatest direct physiological toxicity; several hallucinogens appeared to have the least direct physiological toxicity. Despite residual uncertainties, the subst...Continue Reading

References

May 1, 1979·Journal of Clinical Pharmacology·C T ViswanathanP G Welling
Sep 1, 1979·Annals of Internal Medicine·M K HorneE H Foerster
Dec 1, 1992·The American Journal of Forensic Medicine and Pathology·Olaf H DrummerS M Cordner
Jan 1, 1991·Journal of Psychoactive Drugs·J W AllenK L Jansen
Sep 1, 1990·Journal of Analytical Toxicology·R L KincaidF Rieders
Apr 1, 1990·Forensic Science International : Synergy·D J Pounder, G R Jones
Dec 7, 1989·The New England Journal of Medicine·R A LangeL D Hillis
Feb 1, 1989·Neurology·W S Metzer
Jun 1, 1988·Forensic Science International : Synergy·L RammerH Sandler
Jun 1, 1985·Forensic Science International : Synergy·R R FyshM J Whitehouse
Oct 12, 1984·JAMA : the Journal of the American Medical Association·R E Mittleman, C V Wetli
Jan 1, 1983·Biopharmaceutics & Drug Disposition·J I JavaidJ M Davis
Jan 1, 1982·International Journal of Psychiatry in Medicine·C Van DykeR Byck
Apr 1, 1982·Anesthesia and Analgesia·J C YangF V Mignogna
May 1, 1980·Clinical Toxicology·J Garriott, C S Petty
May 22, 1995·Forensic Science International : Synergy·C L WinekL Rozin
Jan 28, 1995·BMJ : British Medical Journal·N A BuckleyD L O'Connell
Jan 1, 1993·International Journal of Legal Medicine·K WormB Kringsholm
Jan 1, 1994·Journal of Analytical Toxicology·B A GoldbergerJ E Smialek
Jan 1, 1994·Journal of Toxicology. Clinical Toxicology·S M BradberryJ A Vale
Jan 1, 1997·Journal of Toxicology. Clinical Toxicology·M R Repetto, M Repetto
Jun 17, 1998·JAMA : the Journal of the American Medical Association·P M MarzukN Hartwell
Dec 29, 1998·Journal of Toxicology. Clinical Toxicology·S RamcharanJ H Beijnen
Mar 3, 1999·Substance Use & Misuse·Harold Kalant
Jul 15, 1999·Journal of Ethnopharmacology·J C CallawayD C Mash
Sep 28, 1999·Annals of Emergency Medicine·S M GreenS G Rothrock
Aug 10, 2000·The Journal of the American Board of Family Practice·M E Wallace, R Squires
Dec 5, 2000·Behavioural Pharmacology·K J SchuhC E Johanson
Aug 21, 2001·Psychopharmacology·C L HartM W Fischman
Sep 15, 2001·Clinical Pharmacology and Therapeutics·K M RentschK Fattinger
Oct 24, 2001·Forensic Science International : Synergy·H DruidJ Ahlner
Mar 6, 2002·Circulation·Meryem TuncelWanpen Vongpatanasin
May 7, 2002·Journal of Toxicology. Clinical Toxicology·Einosuke Tanaka
Nov 13, 2002·Forensic Science International : Synergy·Christoph MeissnerManfred Oehmichen
Mar 21, 2003·Journal of Toxicology. Clinical Toxicology·Jerrold B Leikin, William A Watson
Apr 19, 2003·QJM : Monthly Journal of the Association of Physicians·I M WhyteN A Buckley
May 22, 2003·Drug and Alcohol Dependence·R L Balster, George E Bigelow
Jun 20, 2003·Addiction·Alison SeymourJohn Oliver
Aug 21, 2003·Forensic Science International : Synergy·R García-RepettoM Menéndez
Oct 1, 2003·Journal of Analytical Toxicology·Joni L HenryTimothy P Rohrig
Dec 5, 1896·British Medical Journal·S W Mitchell

Citations

Jul 3, 2008·Journal of Psychopharmacology·Mw JohnsonRr Griffiths
Nov 15, 2011·The Behavioral and Brain Sciences·Christian P Müller, Gunter Schumann
Nov 13, 2014·Nature Reviews. Neuroscience·Irene Tracey, Rod Flower
Oct 7, 2011·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Jae-Seok ParkSae-Yong Hong
Nov 29, 2011·Forensic Science International : Synergy·Vigdis VindenesJørg Mørland
Oct 20, 2009·Lancet·Wayne Hall, Louisa Degenhardt
Dec 15, 2015·Drug and Alcohol Dependence·Joseph J PalamarDanielle C Ompad
Feb 24, 2009·Neuroscience·E H HagenP Hammerstein
Jun 27, 2007·Alcohol·Richard W OlsenMartin Wallner
Oct 9, 2013·Prevention Science : the Official Journal of the Society for Prevention Research·Joseph J Palamar
Feb 1, 2006·Addiction·Robin Room
Jul 22, 2008·British Journal of Clinical Pharmacology·R E Ferner
Jun 23, 2010·Drug and Alcohol Review·Doug Sellman
Jan 28, 2010·Human Psychopharmacology·Leslie A King, John M Corkery
Jul 27, 2015·Biochimica Et Biophysica Acta·Satyabrata Pany, Joydip Das
Jul 20, 2011·Substance Use & Misuse·Joseph J PalamarPerry N Halkitis
May 11, 2011·Neuroscience and Biobehavioral Reviews·C S E Weston
May 10, 2016·Trends in Pharmacological Sciences·Philippe Coulon, Ali Gorji
Nov 3, 2010·Lancet·David NuttIndependent Scientific Committee on Drugs
Oct 26, 2016·Journal of Substance Abuse Treatment·Karen L DugoshJessica L Lipkin
Feb 26, 2016·The Lancet. Psychiatry·Wayne HallLouisa Degenhardt
Nov 20, 2016·Journal of Psychopharmacology·James RuckerAllan H Young
Dec 2, 2016·The International Journal on Drug Policy·Wayne Hall
Sep 24, 2015·Journal of Psychopharmacology·Peter S HendricksRoland R Griffiths
Sep 20, 2011·Journal of Psychopharmacology·Ruth Weissenborn, David Nutt
Jun 1, 2018·Expert Opinion on Drug Metabolism & Toxicology·Zhibin HuangYulan Rao
Apr 24, 2018·Central European Journal of Public Health·Dorota Rogowska-SzadkowskaSławomir Chlabicz
May 7, 2020·Regional Anesthesia and Pain Medicine·Joel P CastellanosTimothy Furnish
Aug 24, 2018·International Orthopaedics·Shaun H MedinaR Frank Henn
May 22, 2020·Therapeutic Advances in Psychopharmacology·Matthew ButlerJames Rucker
Oct 11, 2017·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Dermot P MaherRonald J Kulich
Sep 2, 2020·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Łukasz Sobczak, Krzysztof Goryński
Jul 22, 2018·Frontiers in Pharmacology·Eduardo Ekman Schenberg

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