title: Chronic drug use confirmed by hair analysis: its role in understanding both the medical cause of death and the circumstances surrounding the death.
abstract: Analysis of hair for drugs is now a well established technique. It is being used increasingly in crime investigation but seldom in routine Coroner's toxicology. Hair analysis is the only method of obtaining a reliable drug history for the weeks or months prior to death. Between 2004 and 2006 from the cases reported to HM Coroner, hair was submitted for analysis in addition to the routine specimens for 286 selected cases. These were all cases where drug use was thought to be involved in the death. The usefulness of the data from hair analysis was evaluated along with the data from the conventional samples. The types of cases were identified where hair analysis provided valuable supporting evidence. It was found that reliable information concerning long-term drug use was important in a wide range of cases including: --demonstrating a history of drug use or lack of it, demonstrating tolerance or lack of it, compliance with medication, death due to long-term cocaine use and its role in depression/suicide, sudden unexplained death, and excited delirium. The cases types are illustrated by reference to individual cases and the implications of the findings discussed. The study demonstrated that hair analysis can provide vital evidence in a wide range of cases reported to HM Coroner. This evidence can be invaluable to the pathologist, Coroner, and the family of the deceased in understanding both the medical cause of death and the circumstances surrounding the death.
authors.affiliation: Toxicology Unit, Imperial College London, Charing Cross Campus, St Dunstan's Road, London W6 8RP, United Kingdom. s.paterson@imperial.ac.uk
authors.forename: Sue
authors.initials: S
authors.lastname: Paterson
authors.forename: Rosa
authors.initials: R
authors.lastname: Cordero
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Stearns
mesh_terms: D000328:Adult; D003645:Death, Sudden / Q000209:etiology; D003693:Delirium / Q000139:chemically induced; D003863:Depression / Q000453:epidemiology; D004361:Drug Tolerance; D005260:Female; D053593:Forensic Toxicology; D006197:Hair / Q000737:chemistry*; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D008297:Male; D055118:Medication Adherence; D004364:Pharmaceutical Preparations; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis*; D013405:Suicide; D055815:Young Adult
chemical_list: D004364:Pharmaceutical Preparations