dextromethorphan and zipeprol

Drug testing plays an important role in the provision of information to health authorities on trends in drug abuse. In the Republic of Korea, the testing of urine and postmortem specimens has been used as part of a programme to monitor and control the abuse of non-controlled drugs, i.e., substances that were not originally included in the lists of controlled substances in that country. Zipeprol, dextromethorphan, carisoprodol and nalbuphine are examples of such drugs, which are widely used as medicines. Increasing levels of abuse of these drugs, including abuse that resulted in fatalities, were confirmed in the Republic of Korea by the results of drug testing. Based on the accumulated data from postmortem specimens, the health authorities in the Republic of Korea subsequently introduced controls on these drugs. A significant drop in fatalities related to the abuse of these non-controlled drugs underlined the importance of timely action for improving community health. In the context of drug testing, the analysis of non-controlled and new drugs always presents a scientific challenge, because specific analytical methods for testing for those drugs are not available. In the Republic of Korea, as part of the drug abuse warning programme, it was necessary to establish methods for the detection and quantification in biological fluids of all four non-controlled drugs and their metabolites in order to monitor the trends in drug abuse. The present paper puts forward epidemiological and clinical data on abuse and fatalities associated with zipeprol, dextromethorphan, carisoprodol and nalbuphine, as well as details of the analytical methods developed.

Topics: Adolescent; Adult; Autopsy; Body Fluids; Carisoprodol; Child; Cross-Cultural Comparison; Dextromethorphan; Drug and Narcotic Control; Drug Interactions; Drug Overdose; Female; Humans; Illicit Drugs; Korea; Male; Middle Aged; Nalbuphine; Piperazines; Population Surveillance; Prescription Drugs; Substance Abuse Detection; Substance-Related Disorders; Suicide; Young Adult

Topics: Adolescent; Adult; Dextromethorphan; Drug Overdose; Female; Humans; Korea; Male; Methamphetamine; Piperazines; Substance-Related Disorders

The abuse of zipeprol, an antitussive agent, was found to be most prevalent among young people in Korea. Because abusers take large doses of this drug for its hallucinogenic effects, fatalities from zipeprol overdose abuse have been on the rise since 1991. Since 1991, a total of 69 zipeprol-related deaths have occurred throughout the nation. A demographic study shows that in ninety six percent of cases involving ziperol alone, the victims were in their teens and twenties. The male/female ratio in zipeprol related death was 3.5:1. Most of these zipeprol-associated deaths occurred in the larger cities of Seoul and Inchon. The blood concentration of zipeprol ranged from 0.8 to 38.3 micrograms/mL in single drug involved deaths, while zipeprol varied from 0.1 to 35.3 micrograms/mL in zipeprol and dextromethorphan victims.

Topics: Adolescent; Adult; Age Factors; Antitussive Agents; Calibration; Chromatography, Gas; Dextromethorphan; Drug Overdose; Female; Humans; Indicators and Reagents; Korea; Male; Piperazines; Sex Factors; Substance-Related Disorders