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Quantitative analysis of amphetamine in femoral blood from drug-poisoning deaths compared with venous blood from impaired drivers.

BACKGROUND
Amphetamine is a major drug of abuse worldwide. Here we compare the concentrations of this stimulant amine in femoral blood in drug fatalities with venous blood from impaired drivers.


METHOD
Amphetamine was determined in blood by isotope-dilution GC-MS after liquid-liquid extraction.


RESULTS
Amphetamine was the only drug identified in 36 fatalities at mean (median) and highest concentrations of 2.0 mg/l (1.5 mg/l) and 14.0 mg/l. In multiple-drug deaths (n = 383), the concentrations were 0.94 mg/l (0.4 mg/l) and 13.3 mg/l. In impaired drivers with amphetamine as the only drug (n = 6138), the concentrations were 1.0 mg/l (0.8 mg/l) and 11.9 mg/l, compared with 0.78 mg/l (0.6 mg/l) and 22.3 mg/l in multidrug users (n = 8250).


CONCLUSION
Fatal amphetamine poisonings cannot be identified on the basis of the concentration in blood alone, owing to the development of tolerance and the toxicity of co-ingested substances.