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Investigation of Deaths From Drug Abuse (From Medicolegal Investigation of Death, P 527-555, 1980, by Werner U Spitz and Russell S Fisher - See NCJ-69730)

NCJ Number
M M Baden
Date Published
29 pages
Characteristics of deaths associated with drug abuse which are noted upon autopsy examination, as presented in a forensic pathology text, are discussed; autopsy findings and criminal investigation are emphasized.
Widespread use of drugs during the past 20 years has been attended by a conspicious increase in deaths related to such drug use. Heroin and methadone abuse have become the leading causes of death for persons between the ages of 15 and 35 who live in New York City. Sustance abuse refers to the socially proscribed or nonmedical taking into the body of any chemical for purposes of producing change in mood, usually some degree of euphoria. In addition to deaths directly caused by injection of heroin, violent deaths such as homicide, suicide, and vehicular accidents are in high incidence in the addict population. Heroin addicts die because of the manner in which the heroin is taken: in unknown and varying quantities with unknown diluents and without sterile procedures. Death may result in a few minutes or hours following injection. The conclusion that death is due to narcotism is based on examination of the scene, investigation of the circumstances, history obtained from relatives and friends, and autopsy findings including toxicologic analysis. Heroin is usually taken in places where addicts are not likely to be disturbed, such as abandoned buildings. Initial examination of the body has been moved, or if there are marks on the body suggesting movement of the body, such as abrasions. Through external autopsy examination, the addict can be identified by linear needle track scars. Internal abnormalities due to narcotism are not prominent at autopsy because long-term use of heroin itself causes no identifiable damage to body organs. Because heroin is rapidly metabolized in the body to morphine, blood, urine, and bile specimen analysis will reveal morphine toxicologically. Methadone abuse presently causes more than twice as many deaths as heroin abuse in New York City. Abuse of nonnarcotic drugs is much more excessive than opiate use. Commonly abused in terms of use are barbiturates, amphetamines, cocaine, L.S.D., and inhalants such as glue. Deaths occur less frequently due to these substances and are usually traumatic, consequent to clouding of the sensorium, transient impairment of judgment, and faulty perceptions resulting in falls and vehicular accidents. Photographs and 10 references are included. For related documents, see NCJ 69731-41 and 69743-47.