Association of Drug Abuse with Deaths Among Cases Autopsied in The Canal Zone

Abstract

Drug abuse is a principle co-morbid factor. In Egypt, very little work was done to study the prevalence of drugs of abuse among the autopsied postmortem cases. The present study was designed in an attempt to determine the prevelance of some common drugs of abuse (opiates, cannabis, benzodiazepines and barbit urates) among one hundred autopsied cases in the area covered by Port Said medicolegal department. Also to determine the impact of these drugs on the different causes and manners of deaths. For every case, a blood and / or urine sample (when available) was used to detect the presence of the tested drugs of abuse by using Thin-Layer Chromatography (TLC). Forty-four percentage of cases were drug positive, 41 % of them were positive for one drug while 3 % were positive for two drugs. The commonest detected drugs were cannabinoids (43.1 %) followed by opiates (36.3 %) then benzodiazepines (27.2 %). Most of the cannabinoid positive cases were homicidal (23.7 %) and accidental (22.2 %) whereas most of the opi ate positive cases were suicidal (20.7 %). Males represented 44.2 % of drug positive cases and females 42.9 %. Most of the drug positive cases were aged below 40 years (46.3 %)whereas 39.4 % aged 40 year or above. The percentage of drug positive cases was 51.9 % from Port Said; 48.1 % from North Sinai and 37 % from Ismailia.As regardthe cause of death, 44.9 % of traumatic deaths were drug positive versus 40.9 % of non-traumatic deaths. Of homicidal autopsied cases, 45.8 % were drug positive (23.7 % were positive for cannabis; 17.9 % were positive for benzodiazepines and 11.9 % were positive for opi ates).Among suicidal deaths, 41.3 % of cases were drug positive (20.7 % were positive for opiates; 10.3 % were positive for cannabis and 10.3 % were positive for benzodiazepines). Although accidental manner of death in the present study represented only 9 % of total autopsied cases yet the drug positive cases constituted 55.6 % of them. Pathological causes of death constituted 3 % of total autopsied cases, 33.3 %of them were drug positive .All cases of accidental deaths due to pedestrian traffic accidents and 75 % of deaths due to falling from heights were drug positive.It can be concluded that TLC is a useful method for detection of drugs of abuse extracted from the blood and / or urine samples of the autopsied cases. Cannabis was the most prevalent drug among the forensic autopsied cases followed by opiates then benzodiazepines.