Unnatural deaths among drug abusers.

BACKGROUND Deaths caused by drug abuse, in which the cause of death is intoxication, so-called overdose deaths, are regularly reported and studied. Other deaths related to drug abuse have been less frequently studied. We wished to investigate the prevalence and characteristics of unnatural deaths in persons in whom drugs were detected in blood samples taken at autopsy. MATERIAL AND METHOD A total of 1,338 forensic autopsy reports from Southern Norway for the years 2000-2005, in which there were positive drug findings in post mortem blood, were aged 20-59 years and had an unnatural manner of death (accident, suicide, homicide) were investigated. Gender, age, cause of death, manner of death, circumstances and police district were recorded. RESULTS The mean age of those included in the study was 34 years, and 81% of them were men. Of all the deaths investigated, 998 of the deceased were in the age group 20-39 years, and 322 deaths were due to accidents other than intoxication (most frequently traffic-related), suicide or homicide. The remaining deaths were accidental intoxications (i.e. intoxications not suspected to be suicides, and which primarily account for the official «overdose statistics»). The proportion of women and the circumstances varied according to the manner of death. INTERPRETATION Unnatural deaths that occur during drug use but are not accidental poisonings are not included in the regular «overdose statistics». These deaths account for a significant proportion, and are in all likelihood being underreported. They are somewhat different from the accidental poisonings in terms of their gender distribution and circumstances.