Methamphetamine as the most common concomitant substance used with pregabalin misuse.

BACKGROUND AND AIM: Non-medical use of Pregabalin (PGB) is a growing concern in many countries because of the serious consequences associated with their abuse. Judicial cases within the probation system, multiple drug users, and patients in treatment programs administered PGB at higher doses than suggested, commonly without prescription. For this reason, it is important to analyze PGB by adding it to the routine analysis scale in determining whether PGB is used for medical purposes or abuse. In this study, PGB analyzed (single or multiple substance use, concomitant substances) in urine samples of forensic and clinical cases by liquid chromatography-tandem mass spectrometry (LC-MS/MS). In addition to the sociodemographic and clinical characteristics of pregabalin-positive cases, the results were evaluated separately from a clinical and forensic perspective. METHODS: All urine samples which was admitted to Addiction Toxicology Laboratory from 'drug abuse probation system' (forensic cases, n = 640) and from various departments of our hospital (clinical cases, n = 371) between December 2022 and April 2023. Screening analysis were carried out by immunoassay in total 1011 cases. LC-MS/MS method simultaneously analyzed amphetamine, benzoilecgonine, cocaine, codeine, metamphetamine, morphine, 3,4-metilenedioksi-N-metilamfetamin (MDMA), 11-nor-9-karboksi-Δ9-tetrahidrokannabinol and pregabalin in urine samples. PGB was added to the our routine substance screening analysis scale in December 2022 to detect pregabalin use. RESULTS: PGB was detected in 12.3% of probabition cases and 13.2% of clinical cases. The mean age of PGB positive cases was 26.55 ± 7,52 years old, predominantly males (%85,9). Single PGB was detected in 53.2% of forensic cases (n = 42), and 38.7% of clinical cases (n = 19). The most common substance detected concomitantly with PGB was amphetamine type stimulants (ATSs:amphetamine, methamphetamine, ecstasy/MDMA etc.) (22.8% of forensic cases and 46.9% of clinical cases), followed by concomitant cannabis use (24.1% of forensic cases and 26.5% of clinical cases). Concomitant opioid use was rare (1.3% of forensic cases and 4.1% of clinical cases). Detection of PGB was significantly different across months on which the samples were collected (x2 = 82.8, df=4, p < 0.001). CONCLUSION: Inconsistently with previous studies suggesting opioids as the most prevalant substances concominant with PGB, our results showed that stimulants (especially ATSs) were the most prevelant substances concominant with PGB, followed by cannabis. High proportion of PGB detection in probabition cases, frequently as a single substance abuse takes attention. These results suggest that PGB, may be used to avoid legal consequences. It is important for laboratories to be aware that they need to make changes as addition of newly abused substances in their analysis panels, when necessary, as differences between regions and cultures affect substance use patterns.

The role of aggression in substance use: The prison case.

OBJECTIVES: Substance use and aggressive behaviour pattern is considered as a serious criminal behaviour threat. This analytical cross-sectional study was designed to determine the level of aggression of convicts with substance use and to determine the variables predicting the substance use characteristics of convicts. METHODS: The study was carried out with 255 male convicts in 2 different closed penal execution institutions in Izmir province. In order to measure demographic variables, data were collected using the Information Form, Buss Perry Aggression Questionnaire and Addiction Profile Index. RESULTS: When convicts were examined according to demographic variables, it was found that there was a significant difference between the groups in terms of variables such as age, marital status, domestic violence, history of psychological treatment and self-harm behaviour. The results showed that 85.5% of convicts had used cannabis more than three times in their lifetime. Also there was a significant difference between the total score obtained from the aggression scale and the number of substance types used. CONCLUSIONS: Multidisciplinary approach in the field of addiction can go a long way in solving the problem and will play an important role in the protection of society, individuals and victims.

Pregabalin Qualitative Detection in Turkish Forensic Cases Between 2017 to 2018.

Pregabalin (PGB) has been commonly subjected to diversion, from being a prescription drug to a recreational drug. In this study, pregabalin use (which is one of the substances subject to control in Turkey) and the concomitant use of other substances in cases admitted to the Izmir Forensic Medicine Institute was evaluated. Samples from 15,259 cases were screened, between June 2017 and December 2018, for the presence of PGB, and PGB positive cases were further analyzed. Of all cases screened, PGB was detected in 3.2% (n = 487). The mean age of PGB positive cases was 29.24 ± 10.34 years old (min: 14, max: 84), and 94% of them were male. Cannabis metabolite THC-COOH was the most common substance detected in the blood samples following PGB. Overall, 8 other substances were commonly used along with PGB. These substances were cannabis, morphine, hydromorphone, codeine, hydrocodone, heroin, paracetamol, and naproxen. Finally, we observed similar results in urine analysis. This research provides systematic data for PGB use in forensic cases in Turkey. The study findings indicate that PGB and multiple drug use increased over time, and providers should be particularly careful when prescribing PGB.

Development of analytical method for illegal substances in sweat and comparison of the effectiveness of sweat collection materials.

PURPOSE: Sweat analysis can yield valuable information in forensic investigations, diagnosis and treatment. The purpose of this study was to develop a validated gas chromatography-mass spectrometric method for the detection of illegal substances in sweat after optimizing the method by chemometric approach. This study also investigated the effectiveness of alternative sweat-collecting materials. METHODS: Plackett-Burman screening design was employed to determine the effect of seven process factors on this new method. Then, central composite design (CCD) was used to optimize the method. The method was validated according to the international guidelines. The effectiveness of alternative sweat-collecting materials (cosmetic pads and swabs) was compared with a commercially available collecting device (DrugWipe5A). RESULTS: Sample pH, ultrasonic bath time, and liquid-liquid extraction (LLE) shaking time were determined as the most significantly effective three parameters with the Plackett- Burman screening design. The validation procedure was successfully performed after optimizing this method. The comparison study demonstrated that cosmetic pads, swabs, and DrugWipe5A can be used interchangeably. CONCLUSIONS: Our results suggested that the statistical optimum strategy was an effective tool for the optimization of process parameters. Combined with the sensitivity and selectivity of our method, the analysis of sweat collection materials proved to be a useful tool for physicians and health care professionals.

Family-based prevention in youth's substance misuse in low- and middle-income countries: A review from Turkey and cultural adaptation of family based interventions.

Family-based interventions have been recognized and practised more in high-income countries than in low- and middle-income countries. However, the threats posed by substance misuse to the youth do not change for the latter. The development of appropriate preventive programs is an area of interest for addiction prevention in low- and middle-income countries by recognizing the risk factors for substance misuse among young individuals. This study aims to present the risk factors primarily in family-based conditions for substance use among young people in low- and middle-income countries and to provide information on family-based interventions that can be developed in line with these factors. It is aimed to discuss how family-based studies can be adapted to samples such as Turkey in the light of three programs originating in the USA. Fifty-six publications gathered from the literature between 1989-2021 by using keywords were included in the study. Adolescence and young adulthood are the riskiest developmental periods for substance misuse worldwide. Economic, cultural and family-based factors involving the youth are of considerable importance. Families' consciousness of youth's substance use is worthful to prevent youth's addictions in the future. Studies show that family-based preventions are promising interventions in this regard.

Investigating the Effects of a Synthetic Cannabinoid on the Pathogenesis of Leukemia and Leukemic Stem Cells: A New Therapeutic Approach.

The popularity and usage of synthetic cannabinoids (SCs) are increasing due to their easy accessibility and psychoactive effects worldwide. Studies on cannabinoids on leukemic stem cells (LSC) and hematopoietic stem cells (HSCs), which are the precursors of leukemia cells, generally depend on the natural cannabinoid delta-9-THC. As there is only a limited number of studies focusing on the results of SC applications, the reflections upon LSCs have to be clarified. In this study, biological responses and antileukemic effects of JWH-018-one of the first produced and widely used SCs-were evaluated upon leukemia cells. Whether JWH-018 exhibited a preventive effect on both leukemic and HSCs was evaluated by presenting a therapeutic approach for the first time in the literature. Cells were analyzed in case of cell proliferation, apoptosis, and transcriptional expression profiling of some significant JAK/STAT and AKT/mTOR pathways, apoptotic, cell cycle regulation, and epigenetic chromatin remodeling-related genes following JWH-018 treatment. In conclusion, however, further studies are still needed upon both HSCs and LSCs to illuminate the effects of SCs on leukemogenesis on chronic myeloid leukemia (CML) more clearly; we consider that the JWH-018 can provide a therapeutic effect on the pathogenesis of leukemia and particularly upon LSCs and SCs might have therapeutic potential in addition to current therapy.

Toxicological evaluation of alcohol and substance abuse in children and adolescents.

Unhealthy behaviors such as use of alcohol and drug usually begin during adolescence. Izmir is on transit route for illicit substance due to geographical situation. Children and adolescents are the most important threatened group in terms of alcohol and substance abuse. In this study, it was aimed to investigate alcohol and substance use profile of children and adolescents in Izmir/Turkey with the toxicological analysis results obtained from Addiction Toxicology Laboratory.Urine and blood samples of 4524 cases at and under the age of 18 years coming from various departments to the laboratory in 2015-2016 were analyzed by enzymatic immunoassay. Information and analysis results of the cases were obtained by retrospective analysis of the hospital system.83,3% of the cases were male and the mean age was 16,69 ± 1,63. Alcohol and/or substance use was determined in 13,2% of the cases. Among the cases with positive results of analysis, cannabis (33%) was mostly detected and was followed by amphetamine type stimulants (ATS, 15%), polysubstance use (15%) and alcohol (13%). While cannabis, polysubstance use and ATS were the most common in male, ethyl alcohol, ATS and benzodiazepine were mostly detected in female. There was a significant increase in the substance use rate in 2016 compared to the previous year.A substance use profile was obtained through drug testing in adolescents who are in the risk group for substance use. In this context, our data will be indicative for the development of new and more effective preventive strategies targeting children and adolescents.

The impact of creatinine reference value: Normalization of urinary drug concentrations.

Many illicit drug users attempt to manipulate urine drug testing; dilution is one of the methods. In screening tests, false-negative results below the cut-off values can create positive results after creatinine normalization. This study aimed to evaluate the impact of a creatinine reference value on the normalization of the drug concentration in diluted urine. The study focused on 25 630 cases and the following information: gender, age, urine collection time, drug screening test results, creatinine concentration (CR), and confirmation analysis result. Mean CR value was 143.71 ± 83.68 mg/dl. There was a significant difference between CR and gender (p = 0.03). The mean CR for women was lower than that for men. The correlation between age and CR was not significant (r = -0.08, p = 0.00). However, after grouping the sample into age groups of 10 years, there was a significant difference between age groups and mean CR (p = 0.00). The mean CR was significantly lower in the 0-9 year age group (n = 34) than in the 20-29 year age group (n = 10 943). According to the urine specimen collection time, CR levels during the early hours of the day (06:00-06:59) were lower than those during the remaining hours (p = 0.00). The highest converted drug-negative to drug-positive results were obtained from 153.23 mg/dl CR reference value. Reference CR values were evaluated according to gender, age, and urine collection time. Different rates of positive results were obtained for each reference value. There is no published local creatinine value for spot urine samples in many countries, including Turkey. This will be useful to develop appropriate normalization models when reporting drug test results.

Determination of synthetic cannabinoids in randomly urine samples collected from probationers in Turkey.

Synthetic cannabinoids are a significant public health and safety problem that complicates drug tests with their ever-changing structures in our country and worldwide. The fact that most synthetic cannabinoids cannot be detected in biological samples by routine drug of abuse screening tests also causes an increase in the use of these substances in return. In this study, 500 urine samples of randomly selected probationers, analyzed with an enzymatic immunoassay test at Ege University Institute of Drug Addiction, Toxicology and Pharmaceutical Sciences (BATI) and tested negative, were then selected for retrospective analysis. Synthetic cannabinoids and their metabolites were quantitatively scanned in the collected urine samples via the liquid-liquid extraction method with the LC-MS/MS. Of the 500 studied urine samples, 108 (21.6%) were positive for 20 synthetic cannabinoids and their metabolites. The two most detected synthetic cannabinoids were 5F-NPB-22 (58%) and (S)-AB-FUBINACA (36%), and their mean concentrations were 72.94 ±â€¯47.51 ng/mL and 5.84 ±â€¯14.7 ng/mL, respectively. These results were also compared with national statistics from the general population. It resulted that immunoassay screening tests used in this study were insufficient, and urine samples should be studied in clinical and forensic cases with a validated chromatographic method.

Substance use frequency and related characteristics among adolescents presenting to an emergency department in Turkey.

It has been reported that drug-related visits to emergency department (ED) by youth have been increased in recent years. We aimed to determine the frequency of, and associated risk factors for, substance abuser adolescents presenting to the emergency department. We conducted a biphasic (retrospective-prospective), observational study of all adolescents, presenting to our emergency department with complaints related to recreational drug use and having a positive urine drug screening from January, 2013 to December 2016. To obtain some spesific data, a telephone interview was done. Baseline demographic and clinical data were obtained. During the study period urine toxicology screen was positive for illicit drugs in 131 (0.9%) patients. The total of substance users by years were respectively 17 (13%) in 2013, 27 (20%) in 2014, 39 (30%) in 2015 and 48 (37%). The median age was 16 years and 65% were male. Majority of substance users (61%) had neuropsychiatric complaint. Amphetamine type stimulants (60%) were the most commonly used substance. Rate of cigarette and alcohol use in this adolescent group was respectively 95% and 88%. This group also had some specific features such as low income (59%) and single-parent family (54%). Our findings suggest that the number of illicit drug use has been steadily increasing among adolescents. The most common identified substance was amphetamine type stimulants. They had poor socioeconomic conditions.

Urine drug-testing tampering approaches: Turkish probationers.

The growing numbers of individual and social problems associated with drug abuse necessitate new approaches in drug-testing systems. Equally, drug abusers may attempt to invalidate drug testing using different methods such as adulteration, dilution and substitution. This study aims to investigate tampering methods commonly used by Turkish substance-using probationers and evaluate their effects on toxicological drug-testing results. Initially, probationer urinary screening test results and laboratory substitution documents were evaluated to investigate the dilution and substitution attempt. Additionally, an experimental study was carried out by using readily available household products (bleach, vinegar, drain opener, eye drops) for adulteration. The effect of these agents was investigated for 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THC-COOH), amphetamine and 3,4-methylenedioxymethamphetamine (MDMA). It was determined that probationers preferred unbranded products (syringes, nylon bottles, etc.) for urine substitution. To detect dilution, screening test results were evaluated along with creatinine values. The variability of mean creatinine values can change the rate of the before-negative and after-positive ratio. For adulteration method, the high amounts of bleach provided false-negative results for THC-COOH and amphetamine, but spiking in any concentration of bleach affected MDMA results, causing a slight increase. Vinegar did not affect the THC-COOH and amphetamine results. However, false-negative results were observed for MDMA, with high amounts of vinegar-spiked urine samples. Drain opener was added in large quantities, and false-negative results were observed for all analytes. Visine eye drops did not have any effect on THC-COOH or amphetamine, but a high quantity of eye drops had a slight decreasing effect for MDMA.

New Psychoactive Substance 5-MeO-MiPT In vivo Acute Toxicity and Hystotoxicological Study.

BACKGROUND: The hallucinogenic tryptamine analog 5-methoxy-N-methyl-N-isopropyltryptamine (5-MeO-MiPT) causes social problems worldwide. There are several studies on the metabolism; however, not more studies were found in the literature on acute toxicity. AIMS: To report the acute toxicity of 5-MeO-MiPT in mice, followed by quantitative toxicological analysis of blood and organs, hystotoxicological and immunohistochemical analysis of tissues and cells. STUDY DESIGN: Animal experiment Methods: In vivo experiments were performed using CD1 adult female mice (n=26). Animals were caged in 4 groups randomly. First group was a control (n=3). Second group was vehicle control (n=3) and injected 150 µL of blank solution (50% dimethyl sulfoxide in saline /0.9% of NaCl). While for acute toxicity experiments, 5-MeO-MiPT was added to a blank solution in order to obtain a dose of 0.27 mg/kg in 150 µL injection (n=10) and the last group were injected 2.7 mg/kg 5-MeO-MiPT in a 150 µL injection (n=10). Quantitative toxicological analysis, hystotoxicological and immunohistochemical analysis were performed. RESULTS: In the toxicological analysis, 5-MeO-MiPT was found negative in biological samples which were control, vehicle control, and 0.27 mg/kg dose mice groups. 5-MeO-MiPT was found 2.7-13.4 ng/mL in blood, 11-29 ng/g in kidney, 15.2-108.3 ng/g in liver, and 1.5-40.6 ng/g in the brain in 2,7 mg/kg injected group. In a low dose of the 5-MeO-MiPT liver section, compared with normal tissues, the difference in staining was statistically significant (p<0.0001). In high-dose of 5-MeO-MiPT, H-score showed that the increase in the number of Caspase-3 positive cells was significant compared to the control (p<0.05). In high-dose of 5-MeO-MiPT, intense Caspase-3 immunoreactivity was observed and the increase in the number of Caspase-3 positive cells compared to the control was statistically significant (p<0.05). In brain section, the statistics of the results obtained from the H-score showed that the increase in the number of Caspase-3 positive cells was significant compared to the control (p=0.0183). In vehicle control liver section, there were few Caspase-8 positive cells characterized by a light brown appearance (p=0.0117). In the high-dose 5-MeO-MiPT group, the numbers of positive cells at low and high doses of 5-MeO-MiPT group were statistically significant compared to the control (p<0.05). In the high-dose 5-MeO-MiPT group, Caspase-8 immunoreactivity was detected in the glomerular structures. Compared to control, the increase in Caspase-8 immunoreactivity was found to be statistically significant (p<0.05). CONCLUSION: Low-dose 5-MeO-MiPT did not cause any serious histopathological effects on the liver, kidney, and brain. High doses induce apoptotic cell death through caspase activity.

Morphine Concentrations in Human Urine Following Poppy Seed Paste Consumption.

Papaver somniferum (opium poppy) is one of the world's oldest medicinal plants which are widely used for medicinal, nutritive and scientific purposes. Turkey is one of the major legal opium poppy producer countries in the world and the seed paste of the poppies is consumed in great deal, even more than 100g per meal. The main objective of this study is to investigate the influence of poppy seed paste ingestion on urine tests for opiates whether or not could lead to opiate positive urine test results. For this purpose, a variety of poppies were used and the morphine content of white, yellow and blue-black poppies were determined as 1.9, 4.0 and 2.6mg/kg, respectively. 100g of these seed pastes were consumed in the breakfast by ten healthy adults enrolled in the study over three days and urine samples were collected before and after the breakfast. Opiate screening analysis was carried out by enzyme immunoassay method and the results were evaluated by two different cut-off values (300 and 2000ng/mL). Morphine confirmation analysis was made by GC-MS system and the chromatographic method was validated in terms of selectivity, extraction efficiency, linearity (25-2000ng/ml), intra-assay precision, accuracy, limit of detection (LOD) and limit of quantitation (LOQ) (3 and 10ng/ml), carryover, matrix effect, dilution integrity and stability. According to cut-off value 300ng/ml, opiate concentrations were found positive up to 48h. For cut-off value 2000ng/mL; this time was up to 12h in collected urine samples after consumption of three different colored poppy seed pastes. In all urine samples, thebaine was detected while the heroin abuse metabolite 6-acetyl morphine (6-AM) was not. Urine drug testing legislation was revised on 2016 in Turkey and opiate screening cut-off values increased from 300 to 2000ng/mL. Overall results have shown that poppy seed paste as food consumption could lead to opiate positive urine test result even if increased cut off levels are used. It can also be deduced that thebaine can be taken as supportive biomarker for poppy seed paste consumption. Awareness of interpretation of urine test results and defining the procedures especially for forensic drug testing must be done in legal aspect to ensure justice for each individual (workplace, traffic, court etc.).

Legal workplace policies for drugs and alcohol in Turkey.

The widespread of individual and social problems related to substance use/abuse provoked the new approaches for workplace drug testing systems in the world. Workplace drug testing laws are constructed to protect the community from the consequences of drug use by workers. In Turkey, the legal arrangements on workplace drug testing exist in Turkish Penal Code, Turkish Labour Law, Workplace Physicians Regulations, Maritime Labour Law and Medical Examination Instructions in Highway Transportation Although Turkey has made the initial attempts to develop homogeneous and reliable regulations for workplace drug testing, a detailed workplace policy for drug testing at workplace has still not been provided.. An amendment has been done in the Regulations on Seafarers and a drug test (marijuana, cocaine, amphetamine like drugs and opiate) has been added into the routine tests to take a "Seafarer Health Report".

Resveratrol attenuates doxorubicin-induced cellular damage by modulating nitric oxide and apoptosis.

Although doxorubicin (DOX) is a commonly used chemotherapeutic agent its clinical use is restricted due to its organ toxicities. The present investigation relates to reducing DOX induced side effects to the liver, kidney and ileum by usage of the antioxidant, anti-inflammatory agent, resveratrol (RES) and to investigate the role of nitric oxide synthase (NOS) in the process. Wistar rats were divided into four groups: control (saline i.p); DOX (20 mg/kg i.p), RES (20 mg/kg i.p) and DOX (20mg/kg i.p)+RES (20 mg/kg i.p). Immunohistochemical activity of both iNOS and eNOS were evaluated after DOX treatment and ultrastructural changes such as cellular damage and mitochondrial degeneration were evaluated. Degenerative ultrastructural changes were demonstrated especially in the DOX treated group. Variations in biochemical marker levels of oxidative stress on ischemia in tissues were not observed. Our data indicate that RES may prevent cellular damage in the early phase of DOX induced toxicity. RES could be used with its beneficial effects during early cellular damage in organ toxicity after DOX treatment in cancer patients.

Prevalence of alcohol in blood samples from traffic accident cases in Turkey.

Alcohol is one of the main causes of traffic accidents worldwide. With a population of 70 million, 12 million vehicles, and 18 million drivers (16% women), Turkey is one of the European countries that has a high incidence of road traffic accidents.In accordance with Turkish laws, subjects were considered to be positive when alcohol blood concentration exceeded 50 mg/100 mL. The objective of the present study was to obtain reliable and comparable data about alcohol use in traffic cases in Turkey. All cases are admitted to the emergency department at Ege University Medical Faculty. The cases from police officers are described as traffic control cases. Alcohol was detected in the blood of about 54.4% of the traffic-related cases during October 2005 to March 2007. It has been observed that, in 17.4% of the traffic accident cases, the blood alcohol level was 50 mg/dL or less, which is the legal limit in Turkey for car drivers. Alcohol prevalence was 57.2% in male cases and 43.6% in female cases. In alcohol-positive cases; the ratios for males were 1.73 times more frequent in traffic-related cases. Prevalence data will help traffic safety professionals to adequately allocate resources and plan future efforts in reducing drinking-and-driving behavior and thereby reduce traffic accidents.

Evaluation of neuropsychological symptoms and exposure to benzene, toluene and xylene among two different furniture worker groups in Izmir.

This study was conducted to determine whether there was any exposure to toluene, xylene and benzene and to assess the health impact of these solvents on workers in furniture enterprises in Karabaglar, Izmir. This cross-sectional study covered furniture enterprises in Karabaglar, Izmir. This study was comprised of an exposed group consisting of workers engaged in painting and varnishing and therefore exposed either directly or indirectly toluene, xylene and benzene in the workplace and the non-exposed group engaged in other aspects of production. While a total of 261 individuals completed questionnaires, 210 workers agreed to provide blood samples. Blood solvents levels were determined using gas chromatograph at Ege University, Intoxication Research and Application Centre. The modified EUROQUEST questionnaire was used to assess neuropsychological symptoms and neurological and general examination were performed. Occupational and exposure history, demographic and work-related information was collected. In this study of workers, blood toluene and benzene levels were found to be significantly higher among those engaged in painting and varnishing compared to those who perform other tasks. The average blood toluene and benzene concentrations among exposed workers were 6.95 times and 1.64 times respectively higher than those in the nonexposed groups. Smokers and participants who worked in excess of 8 hours/day had higher blood toluene and benzene levels. The most frequently work-related health complaints were back pain, allergies and asthma. No differences were found in the average scores in the neuropsychological symptoms questionnaire between exposed and non-exposed groups. Neurological examination of two individuals with these complaints revealed a loss of reflexes. The workers were unaware that they were being exposed to solvents at work. Tobacco smoke is a major source of internal exposure to benzene. Improving working conditions in furniture work places is a priority.

[Alcohol use-related problems in women]. / Kadinlarda alkol kullanimi ve buna bagli sorunlar.

It is well known that the prevalence of alcohol use disorders is increasing and represents an important health problem worldwide. Nonetheless, there are an insufficient number of population-based prevalence studies on alcohol use disorders among the general population and women in Turkey. Among the studies performed in Turkey, it has been reported that alcohol use disorders are more common among males and that alcohol use among females is increasing, as in other countries. The alcohol use among females differs from males' in many respects. The purpose of this article was to review the physical differences between males and females relevant to the metabolism of alcohol, and to organic and mental problems caused by alcohol use. In addition we sought to draw attention to the necessity for effective preventative and treatment methods for women.

Rapid communication: postmortem distribution of organophosphate insecticides in human autopsy tissues following suicide.

Organophosphate insecticides (OP) are used widely in Turkey and are the most common agent employed for suicidal poisoning. At present there are limited data available on the distribution of OP in humans, and the aim of the study was to report insecticide concentrations in human autopsy tissues. With the use of gas chromatography-nitrogen phosphorous detector, the levels of fat, liver, and blood OP were determined from 32 suicide victims. In all cases OP were present and usually more than one OP was found. The concentration of OP was highest in fat and least in blood. Even 20 d postmortem OP could be detected in human autopsy tissues, but the correlation to fat content and mortality needs to be addressed.

Fatal poisonings in the Aegean region of Turkey.

Between January 1996 and November 2000, 4,251 autopsies were performed at the Council of Forensic Medicine, Morgue Specialization Office, Izmir, Turkey. Among these medicolegal autopsies, 331 fatal poisoning cases (206 men and 125 women) were evaluated retrospectively for their legal investigation results, autopsy findings, and reports of toxicological analyses. The most common cause of fatal poisoning was insecticides (43%). Then followed carbon monoxide (27%) and alcohol (20%). Among the insecticides, the organophosphorus insecticides comprised 78%; all insecticide poisoning cases were suicidal oral ingestions. In fatal alcohol poisoning cases the cause of death was ethanol, methanol and both with 34, 15 and 51% respectively. Drug related deaths were rare.