Post-mortem toxicology of commonly-abused drugs

Post-mortem redistribution and other changes present major obstacles to the interpretation of drug concentrations in the dead. Nevertheless, reasonable assessments can still be made by the pathologist and toxicologist as to the contribution that commonly-abused drugs may have made to the death. The best assessments may be obtained by the implementation of the investigation along the following lines: (1) carefully select, store, preserve and utilize the post-mortem tissue samples intelligently for appropriate toxicological and histological analyses; (2) use as much information concerning the circumstances of the demise as possible to guide the procedures in step 1; (3) factor in prevalence of drug use and estimated fatality risks of such use within the particular group concerned to determine whether or not additional analytical work is required; (4) consider how these drugs behave in the body ante- and post-mortem, with and without disease states, together with any other factors such as tolerance; (5) consider the toxicological results in the context of macroscopic and histological autopsy findings.