In the present study, one of the objectives was to demonstrate the gender and the age group of the victims that have died from poisoning in the past two years. Males, aged between 21-30 years, accounted for 85.07% of the cases that were studied. This was followed by the 31-40 years age group. This means most of the younger age groups are exposed to various drugs and toxins. This may be due to low socio-economic status, curiosity, stress, peer pressure, and the list goes on. In a 25-year autopsy study conducted by Dalbir Singh et al in Northern India, the victims were mostly males (69%) and the most vulnerable were the ones between the ages of 14 and 30 (68%). In another study carried out in Jamaica, there was a male preponderance, and the 20-29 years individuals were most frequently affected.[6,7] A 10-year Indian study also demonstrated that maximum cases (49.07%) fell in the 15-25 years age group. It also shows a higher percentage of male victims than females.[8] This supports the idea that the youth are the ones that are making up the majority of poisoning mortality cases.
The present study shows that morphine is the agent most commonly detected in poisoning mortalities. This indicates a changing trend, as most cases were found lying in the narcotics and hallucinogens category. Morphine was followed by Dextromethorphan, a cough suppressant, and codeine. Relatively fewer pesticides & insecticide poisoning cases were seen. This is in contrast to other studies carried out for this purpose. For example, in a study carried out in Western India, maximum deaths were due to agricultural products (82.8%), predominantly by organophosphates.[9] Nevertheless, drug toxicity was reported in 10.8% of cases and was found to be the second commonest cause. The drugs abused were mostly NSAIDs and antipyretics. However, it should be pointed out there has been a rising trend in opioid-related overdose deaths in the world. An American study points out that there has been an almost fourfold rise in opioid overdose deaths from 1999 to 2008.[10] A study in Florida documents that the mortality rate from prescription drugs has risen about 84.2%, and that the death rate from prescription drugs has shown a significant rise as compared to illicit drugs.[11]
In another study conducted in Karachi, most poisoning mortalities were reported due to drug overdose.[12] This is a recent study and it further highlights that the trends are changing. Nowadays, we are more likely to encounter drug poisoning as compared to that by pesticides as past studies signified. But that is not necessarily so. Some studies still show that pesticide-related deaths are more commonplace than that by any other agent, for example, this study in Punjab India showed that they make up 17.6% of all the unnatural deaths.[13]
A 5 year study, conducted in Peshawar, to document the drugs of abuse present at autopsy found Diacetylmorphine (heroin) to be the most commonly encountered substance, making 65.38 %, share of the total cases.[14] This probably points to easy access and heroin addiction trends in that locality. In the present study, we encountered 6 cases of heroin-related deaths.
In this study, benzodiazepines appeared to contribute to death in many cases. Diazepam and Nordiazepam (each contributing 16.4%) were the benzodiazepines mostly responsible. A study conducted in Britain also found Diazepam to be the major contributor to poisoning fatalities from benzodiazepine overdose.[15]
Dextromethorphan-related deaths were found second to morphine. This is an easily available, over-the-counter drug. Its addiction is now rising with time. It has contributed to poisoning mortalities that have been studied as well.[16]
This study displayed the present trends in age, gender, and toxic agent in poisoning cases. However, it has some drawbacks that future studies can improve upon. Future studies should try to study more cases for better accuracy and judgment. Ours was not a multi-centric study, though it was conducted in that university that received the major share of autopsy cases in the city. A multi-centric study would give us a better idea of poisoning trends in the area.