SOFT 2004 Meeting Abstracts - Society of Forensic Toxicologists

P31
TRENDS IN THE DETECTION OF DRUGS OF ABUSE IN POSTMORTEM SAMPLES
Bernard Croal"', Stephen Duncan, Daniel Docherty and Patricia Rooke, Department of Clinical
Biochemistry, Aberdeen Royal Infirmary, Aberdeen, Aberdeenshire, AB25 2ZD, UK
Introduction: Drug misuse is a major social and economic problem facing the Grampian and Highland
regions of Northern Scotland. The Oil and Fishing industries have brought wealth and reduced
unemployment in these regions. Consequently, drug dealers have targeted these areas as a potential market
for the selling of drugs. As a result, there has been a dramatic increase over the last decade in the number
of samples screened for drugs-of-abuse in Grampian. Unfortunately, the rise in drug misuse has also seen
an increase in the number of drug related deaths in Grampian and Highland over this time. Fatalities from
suspicious causes are frequently associated with illegal drug misuse. We have assessed the trends of the
presence of commonly abused illicit drugs in post-mortem specimens from individuals who died under
suspicious and accidental circumstances in Grampian and Highland from 1994 to 2000.
Methods: Post-mortem data was obtained from an archival laboratory database of forensic cases for
accidental or suspicious death over the period 1994 to 2000. Drug trends were assessed in cases in which
at least one drug was detected. The drugs chosen for this investigation included Amphetamine, 3,4­
Methylenedioxyamphetamine (MDA), 3,4-Methylenedioxymethamphetamine (MDMA; Ecstasy),
Cannabinoids, Benzoylecgonine, Cocaine, Codeine, Diazepam, Dihydrocodeine, Methadone, Morphine and
6-Monoacetylmorphine, since they represented the most commonly abused drugs found in Grampian and
Highland. Drug detection was assessed from post-mortem blood and urine specimens collected into plain
tubes and extracted by liquid-liquid or solid-phase extraction using either GC-MS or HPLC for detection.
Results: A total of 2993 forensic cases were referred for analysis over the six year period. There was no
evidence that the number ofcases was increasing (mean =458 cases per year, regression coefficient:: 9.57,
p 0.51). From these cases, 641 positive drug screens were obtained from a total of 330 individuals. A
rising trend (regression coefficient; significance level) from 1994 to 1999 was observed for the presence of
Cannabinoids (6.29; 0.002), Codeine (5.77; 0.006), Diazepam (6.89; 0.002), Dihydrocodeine (3.26; 0.002)
and Morphine (7.43; 0.004). Overall, a rising trend was observed for the presence of at least one drug
(regression coefficient 13.89; p :: 0.001), with the finding of more than one drug being present also
increasing.
Conclusions: From 1994 to 2000 the number of positive drug tests in post-mortem specimens from this
source are increasing on average by 37 cases per year. Ofthese, the number of patients with more than one
positive drug is also increasing. This would fit in with the view that drug abuse is increasing within society,
as is multiple drug use. Overall this study provides evidence that drugs of abuse are increasingly implicated
or associated with death from suspicious causes. This evidence ofthe increasing involvement of drug abuse
in fatalities arising from suspicious and accidental causes will strengthen the demand for increasing
specialised toxicological analysis by the Procurator Fiscal, which will have profound economic and
resource implications upon laboratories both in Grampian and nationally.
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