Alcohol and Benzodiazepines in Fatal Poisonings

doi:10.1111/j.1530-0277.2002.tb02627.x

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Wiley InterScience

Alcoholism: Clinical and Experimental Research

Volume 26 Issue 7, Pages 956 - 959

Published Online: 11 Apr 2006

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Alcohol and Benzodiazepines in Fatal Poisonings

Anna Koski ¹ , Ilkka Ojanperä ¹ , Erkki Vuori ¹

¹ Laboratory of Toxicology, Department of Forensic Medicine, University of Helsinki, Finland.

Reprint requests: Correspondence: Anna Koski, Department of Forensic Medicine, P.O. Box 40, FIN-00014, University of Helsinki, Finland; Fax: +358–9–191–27518; E-mail: anna.koski@iki.fi

KEYWORDS

Poisoning • Ethanol • Benzodiazepine • Interaction • Postmortem

ABSTRACT

BackgroundPostmortem forensic toxicology frequently finds alcohol both alone and in combination with drugs. Although benzodiazepines are generally considered safe, they are considered dangerous with alcohol.

MethodsA retrospective statistical analysis of alcohol and benzodiazepine concentrations in postmortem blood samples included 808 cases diagnosed as fatal alcohol or drug intoxication involving (1) ethanol alone; (2) ethanol with temazepam; or (3) ethanol with any combination of diazepam, chlordiazepoxide, and nordazepam.

ResultsThe median concentration of ethanol was 3.3‰ in cases with ethanol alone and 3.5‰ when diazepam was present, but it was significantly lower, only 2.5‰, when temazepam was present in the blood. Furthermore, the median concentration of ethanol was 2.2‰ in cases with high concentrations (>0.9 mg/liter) of temazepam and 2.7‰ in cases with therapeutic (≤0.9 mg/liter) concentrations.

ConclusionsDiazepam and chlordiazepoxide pose a smaller risk of death by poisoning than does temazepam when given as a hypnotic to patients suffering from alcoholism.

December 19, 2001; April 3, 2002

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1530-0277.2002.tb02627.x About DOI