Drugs may be the cause of death, contribute to the cause of death, or contribute to the circumstances surrounding a death. There are many different types of drugs, both legal and illicit, that may be the cause of death. Any drug or chemical taken in excess can cause death. This includes illicit drugs, over-the-counter medicines, and prescription drugs.
Common drugs of abuse encountered in death cases include ethyl alcohol, barbiturates, pain killers, stimulants such as cocaine and methamphetamine, heroin, morphine, LSD, marijuana, and antidepressants. These drugs can readily be discovered through routine postmortem drug screens by testing blood, urine, or other tissues. Chemicals such as carbon monoxide and cyanide may be involved. Blood and urine are not usually tested for these chemicals; however, the circumstances of death may lead the examiner to suspect these chemicals as a cause of death (such as carbon monoxide in fire). Special samples such as hair may be needed to test for cases of heavy metal poisoning, such as arsenic.
Autopsy findings may vary from obvious signs of drug abuse to a negative autopsy. Chronic intravenous drug abusers have easily recognizable needle tracks while chronic alcoholics may have cirrhosis of the liver and bleeding abnormalities. Drugs as a cause of death should be suspected in a negative autopsy in which there is no obvious cause of death. As a general rule, all postmortem examinations should include a drug screen because drugs may play a part in any type of death. Good investigation is needed to rule in or out the possibility of drugs playing a part in someone's death. Except for alcohol, any drug which contributes in any way to a person's death will change the manner of death from natural to accident, suicide, or homicide.
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