12-18 Yaş Arası Ergen Ölümlerinde Bağımlılık Yapıcı Madde Kullanımının Yeri

Öz

Amaç: Her geçen gün artmakta olan bağımlılık yapıcı madde kullanımı ergenler arasında ciddi sağlık sorunlarına hatta ölümlere neden olmaktadır. Bir halk sağlığı problemi olan madde kullanımın küçük yaştaki çocuklar arasında sık olarak görülmeye başlaması bu durumun çocuk ölümleri arasında üst sıralara gelmesine neden olmuştur. Bağımlılık yapıcı madde kullanım yaygınlığı hakkında daha kapsamlı bilgiler edinmek, koruyucu çalışmalar için gerekli ve önemli bir adımdır. Yöntem: Bu çalışma kapsamında Adli Tıp Kurumu Ankara Grup Başkanlığında retrospektif olarak 5 yıllık dosyalar taranmış olup, 12-18 yaş aralığında otopsisi yapılan 258 vakanın otopsi raporları, adli tahkikat dosyaları ve toksikolojik analiz sonuçları incelendi. Çocukların yaşları, cinsiyetleri, ölüm nedenleri, ölüm orijini, kan alkol ve bağımlılık yapıcı madde düzeyleri Excel programı üzerine kaydedildi ve Jamovi programı kullanılarak istatiksel olarak analiz edildi. Bulgular ve Sonuç: Çalışmamızda 12-18 yaş grubu ölümlerinin kanında en sık saptanan bağımlılık yapıcı madde %10,5 oranla alkol olduğu belirlenmiştir. 12- 18 yaş arası ölümlerde kanda uyuşturucu-uyarıcı madde oranı ise %5 olarak tespit edilmiştir. Ergenlik döneminde ölümle sonuçlanan olaylarda en sık rastlanan alkol dışı bağımlılık yapıcı maddenin uçucu maddeler olduğu tespit edilmiş olup özellikle gelişmekte olan ülkelerde uçucu maddelerin satışının denetlenmesi ve riskli grupların psikiyatrik açıdan desteklenmesi gerekmektedir.

Anahtar Kelimeler

• Uçucu maddeler
• madde kullanım bozukluğu
• ergen ölümleri

The Role of Addictive Substance Use in Adolescent Deaths Between 12-18 Years of Age

Öz

Aim: The increasing use of addictive substances day by day is causing serious health problems and even deaths among adolescents. Obtaining more comprehensive information about the prevalence of addictive substance use is a necessary and important step for preventive studies. Methods;Within the scope of this study, 5 years of files were scanned retrospectively at the Ankara Headquarter, Council of Forensic Medicine, and then the autopsy reports, forensic investigation files, and toxicological analysis results of 258 cases whose autopsies were performed between the ages of 12–18 were examined. The children’s ages, genders, causes of death, origin of death, blood alcohol, and addictive substance levels were recorded on the Excel program and statistically analyzed using the Jamovi program. Results;In our study, it was determined that the most commonly detected addictive substance in the blood of deaths in the 12-18 age group was alcohol, with a rate of 10.5%. In deaths between the ages of 12-18, the rate of narcotic-stimulant substances in the blood was determined to be 5%. It has been determined that the most common non-alcohol addictive substances in fatal incidents during adolescence are volatile substances. Conclusion:The findings of this study indicate that alcohol consumption and the use of sedative and stimulant substances play a significant role in deaths among the adolescent age group. The development of effective strategies aimed at preventing alcohol and substance use within this demographic—particularly by policymakers, public health professionals, and mental health experts—has the potential to reduce mortality rates

Anahtar Kelimeler

• Volatile substances
• substance use disorder
• adolescent deaths

Kaynakça

1. 1. Republic of Turkey Ministry of Interior General Directorate of Security Department of Anti-Smuggling and Organised Crime, Turkish Drug and Drug Monitoring Centre (TUBIM). 2012 Turkey Drug Report. Anka-ra: TUBIM; 2012.
2. 2. Bı̇ Laç, Ö., Kavurma, C., Önder, A., Doğan, Y., Uzunoğlu, G., Ozan, E. (2019). Clinical and socio-demographic characteristics of young people receiving inpatient treatment for substance abuse in a regional mental health hospital child and adolescent inpatient service. Journal of Clinical Psychiatry, 22(4),463-471. https://doi. org/10.5505/kpd.2019.30075
3. 3. Zazoğlu, S., Savaş, H., Ketenci, H. Ç., Beyhun, N. E., A description of the profile of narcotics and new generation psychoactive substances sent by the judicial authorities to the Turkish Council of Forensic Medicine Trabzon Group Chairmanship between 2010 and 2014. Turkish J. Forensic Med. 2017, 31 ,1-5. https://doi.org/10.5505/adlitip.2017.14238
4. 4. Aslan, Rukiye, Alev Aktaş, and Serap AKGUR. “Substance Use in Children and Adolescents and Fo-rensic Toxicological Analyses.” Journal of Addiction 24.1 (2023): 93-103. https://doi.org/10.51982/bagimli.1071269
5. 5. Ögel, Kültegin. “Epidemiology of substance use disorders.” Türkiye Klinikleri Journal of Internal Med-icine Psychiatry 1.47 (2005): 61-4.
6. 6. Türkiye İstatistik Kurumu (TÜİK). Ölüm ve Ölüm Nedeni İstatistikleri, 2023 [Internet]. Ankara: TÜİK; 2024 [cited 2025 Jul 31]. Available from: https://data.tuik.gov.tr/Bulten/ Index?p=Olum-ve-Olum-Nedeni-Istatistikleri-2023-53709
7. 7. Tatar, G., et al. “Analysis of medico-legal deaths in adolescents and young people in Izmir (Tur-key).” Journal of Aegean Medicine 53.1 (2014): 25-32.
8. 8. Sauvageau, Anny, and Stephanie Racette. “Child and adolescent victims in forensic autopsy: a 5-year retrospective study.” Journal of forensic sciences 53.3 (2008): 699-702. https:// doi.org/10.1111/j.1556-4029.2008.00695.x

9. 9. Balcı, Yasemin, et al. “Evaluation of the Cases of Youth Age Group Autopsied in Muğla.” Bulletin of Forensic Medicine 23.3 (2018): 156-161. https://doi.org/10.17986/blm.2018345598
10. 10. Okoye, Cordelia N., and Matthias I. Okoye. “Forensic epidemiology of childhood deaths in Nebraska, USA.” Journal of forensic and legal medicine 18.8 (2011): 366-374. https://doi. org/10.1016/j.jflm.2011.07.013
11. 11. Aktepe E, Demirci AC, Ozer S, Sönmez Y, Sönmez B. Evaluation of sociodemographic and psychiatric characteristics in children and adolescents who attempted suicide. TAF Prev Med Bull. 2006;5(6):430–40.
12. 12. Savaşan A, Oktay D. Çocuklarda ve ergenlerde alkol bağımlılığı. Öztürk C (ed). Çocuklarda Bağımlılık ve Hemşirelik Yaklaşımları. 1. baskı. Ankara: Türkiye Klinikleri; 2021. s. 23–28.
13. 13. Garofoli, Mark. “Adolescent Substance Abuse.” Primary care 47.2 (2020): 383-394. https://doi.org/10.1016/j.pop.2020.02.013
14. 14. Yang, M. S., et al. “Prevalence and related risk factors of licit and illicit substances use by adolescent students in southern Taiwan.” Public Health 112.5 (1998): 347-352. https://doi. org/10.1016/S0033-3506(98)00268-6
15. 15. Alikaşifoğlu, Müjgan, and Oya Ercan. “Substance use in adolescents.” Turkiye Klinikleri Pediatric Sci-ences-Special Topics 2.5 (2006): 76-83.
16. 16. İmre, O. “Trends and Determinants of Alcohol Consumption in Turkey.” Acta Medica Ruha 3.1 (2025): 1-5. https://doi. org/10.5281/zenodo.14991235
17. 17. Temel, Emine Türkyılmaz. Retrospective examination of the cases in which alcohol, narcoticdrug and stimulant substances were detected in the cases autopsied in Bursa Group Presidency of Forensic Medicine Institute between 2018-2020. MS thesis. Bursa Uludag University (Turkey), 2022.
18. 18. Kadı G, Güvenç Çekiç E, Erbaş M, et al. Evaluation of Ethyl Alcohol Level in Autopsied Cases. Muğla Sıtkı Koçman University Med. 2016; 3(3):1-4
19. 19. Balcı Y, Gurpinar K, Kara E, Savran B. Evaluation of deaths due to intoxication among medicolegal au-topsies in Muğla. Turkish J Forensic Med. 2020; 34(1):39-49 https://doi.org/10.5505/adlitip.2020.37167
20. 20. Karadeniz, Hülya, et al. “A case report of sudden death due to lighter fluid inhalation among adoles-cents.” Bulletin of Forensic Medicine 21.1 (2016): 55-58. https://doi.org/10.17986/ blm.2016116604
21. 21. Pfeiffer, H., et al. “Sudden death after isobutane sniffing: a report of two forensic cases.” International journal of legal medicine 120.3 (2006): 168-173. https://doi.org/10.1007/s00414- 005-0062-x
22. 22. Engelgardt, Piotr, et al. “Life time use of illicit substances among adolescents and young people hospital-ised in psychiatric hospital.” Scientific reports 13.1 (2023): 1866. https://doi. org/10.1038/s41598-023-28603-2
23. 23. Svensson T, Baigi A, Markides K, Thulesius H. Major trauma and the socioeconomic status: A popula-tion-based case– control study in Malmö, Sweden. Eur J Trauma Emerg Surg. 2016;42(4):419–426. doi:10.1007/s00068-015-0542-1 https://doi. org/10.1007/s00068-015-0542-1
24. 24. Seye MN, Ndour O, Ka MM, Sow ML, Diop BM. Homicides in Dakar: Epidemiological and medicolegal aspects. Med Trop (Mars). 2011;71(6):635–638. Available from: https://pubmed. ncbi.nlm.nih.gov/22281212/
25. 25. Khgari M, Sardari-Iravani F, Ghadipasha M. Trends in Poly Drug Useassociated Deaths based on Con-firmed Analytical Toxicology Results in Tehran, Iran, in 2011-2016. Addict Heal. 2021; 13(1):18.
26. 26. Karcı, Canan Kuygun, et al. “Psychiatric comorbidity, addiction profile and treatment request in sub-stance using adolescents: ÇEMATEM data.” Journal of Addiction 23.1 (2022): 61-68. https://doi.org/10.51982/bagimli.956300
27. 27. Ogel, K., S. Taner, and C. Y. Eke. “Prevalence of alcohol and substance use among tenth grade students: Istanbul sample.” Journal of Addiction 7.1 (2006): 18-23.