From Substance Use Disorders in Life to Autopsy Findings: A Combined Case-Record and Medico-Legal Study
Abstract
:1. Introduction
2. Methods
2.1. Forensic Examination
2.2. Case Record Evaluations and Interviews
2.3. Statistics
3. Results
3.1. Case Records: Diagnoses, Suicidal Behaviour, and Misuse
3.2. Autopsy: Manner of Death and Substance Use
3.3. Autopsy: Substances Used/Not Misused in Life and Found at Autopsy by Unnatural and Natural Death
3.4. Autopsy: Substances Detected and Violent Manner of Self-Inflicted Death
3.5. Autopsy: Violent Death
3.6. Autopsy: Contribution to Death by Substances Found
3.7. Case and: Depression and Antidepressants
4. Discussion
4.1. Main Findings
4.2. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Misuse | Suicidal Ideation | Suicide Attempt | Diagnoses | Depression |
---|---|---|---|---|
Heroin (n = 49) | 8 (16) | 18 (37) | 17 (35) | 3 (6) |
CNS-S (n = 63) | 12 (19) | 23 (37) | 22 (35) | 5 (8) |
Cannabis (n = 56) | 7 (13) | 18 (32) | 14 (25) * | 4 (7) |
Benzodiazepines (n = 91) | 27 (30) | 33 (36) | 40 (44) | 5 (5) |
Legal opioids (n = 35) | 11 (31) | 15 (43) | 16 (46) | 2 (6) |
Alcohol only (n = 231) | 35 (15) | 29 (13) | 76 (33) | 11 (5) |
All; including alcohol only (N = 365) | 70 (19) | 73 (20) | 130 (36) | 20 (5) |
Substance | Mean Number of Drugs Used in Life |
---|---|
Heroin | 3.51 (±0.982) |
Central stimulants | 3.17 (±1.129) |
Cannabis | 3.13 (±1.237) |
Benzodiazepines | 2.34 (±1.400) |
Legal opioids | 2.91 (±1.463) |
All; including alcohol only | 0.80 (±1.314) |
Heroin | CNS-S | Cannabis | Benzodiazepines | Legal Opioids | Alcohol Only | |
---|---|---|---|---|---|---|
Natural death n = 194 (53%) | 13 (27%) | 15 (24%) | 15 (20%) | 29 (32%) | 9 (26%) | 150 (65%) |
Violent death n = 18 (5%) | 6 (12%) | 4 (6%) | 3 (5%) | 5 (6%) | 2 (6%) | 10 (4%) |
Suicide n = 44 (12%) | 4 (8%) | 7 (11%) | 8 (14%) | 10 (11%) | 2 (6%) | 27 (12%) |
Death of undetermined intent n = 87 (24%) | 7 (14%) | 18 (29%) | 14 (25%) | 30 (33%) | 11 (31%) | 44 (19%) |
Heroin overdose n = 22 (6%) | 19 (39%) | 19 (30%) | 16 (29%) | 17 (19%) | 11 (31%) | 0 (0%) |
Total self-inflicted death n = 153 (42%) | 31 (63%) | 44 (70%) | 39 (70%) | 57 (63%) | 24 (69%) | 71 (31%) |
Total n = 365 (100%) | 49 (100%) | 63 (100%) | 56 (100%) | 91 (100%) | 35 (100%) | 231 (100%) |
Substances Used/Misused in Life | Mean Number of Drugs Found at Autopsy |
---|---|
Heroin | 2.31 (±1.262) |
CNS-S | 2.29 (±1.197) |
Cannabis | 2.20 (±1.182) |
Benzodiazepines | 1.97 (±1.251) |
Prescription opioids | 2.49 (±1.197) |
Alcohol only | 1.12 (±0.879) |
All; including alcohol only | 1.43 (±1.094) |
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Brådvik, L.; Löwenhielm, P.; Frank, A.; Berglund, M. From Substance Use Disorders in Life to Autopsy Findings: A Combined Case-Record and Medico-Legal Study. Int. J. Environ. Res. Public Health 2019, 16, 801. https://doi.org/10.3390/ijerph16050801
Brådvik L, Löwenhielm P, Frank A, Berglund M. From Substance Use Disorders in Life to Autopsy Findings: A Combined Case-Record and Medico-Legal Study. International Journal of Environmental Research and Public Health. 2019; 16(5):801. https://doi.org/10.3390/ijerph16050801
Chicago/Turabian StyleBrådvik, Louise, Peter Löwenhielm, Arne Frank, and Mats Berglund. 2019. "From Substance Use Disorders in Life to Autopsy Findings: A Combined Case-Record and Medico-Legal Study" International Journal of Environmental Research and Public Health 16, no. 5: 801. https://doi.org/10.3390/ijerph16050801