title: Concentration distributions of the drugs most frequently identified in post-mortem femoral blood representing all causes of death.
abstract: Interpreting the concentrations of drugs determined in post-mortem blood is not an easy task owing to poly-drug use, adverse drug-drug interactions, as well as a host of pre-analytical factors and various artefacts in post-mortem toxicology. Highly sensitive and specific methods (GC-FID, GC-NPD. GC-MS and LC-MS) were used to determine the concentrations of drugs in femoral blood from 24,876 autopsies representing all causes of death. Ethanol topped the list of psychoactive substances (N=8108 or 33%) at mean, median and highest concentrations of 1.43 g/L, 1.20 g/L and 8.0 g/L, respectively. In second place was paracetamol (N=2741 or 11%). Amphetamine and cannabis were the major illicit drugs at 13th and 15th positions, respectively. Newer antidepressants, citalopram (no 3), sertraline (no 14), venlafaxine (no 16) were prominent as were sedative-hypnotics, such as diazepam (no 4), zopiclone (no 5) and zolpidem (no 18). This compilation of drugs and their concentration distributions will be useful to identify and flag for a likely overdose or drug-related poisoning death. The drug concentration together with the findings at autopsy and the police report can then be used to reach a conclusion about the cause and manner of death.
authors.affiliation: Department of Forensic Toxicology, Artillerigatan 12, 58758 Linköping, Sweden. wayne.jones@rmv.se
authors.forename: Alan Wayne
authors.initials: AW
authors.lastname: Jones
authors.forename: Anita
authors.initials: A
authors.lastname: Holmgren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002492:Central Nervous System Depressants / Q000097:blood*; D002648:Child; D002849:Chromatography, Gas; D000431:Ethanol / Q000097:blood*; D005260:Female; D053593:Forensic Toxicology; D006801:Humans; D013287:Illicit Drugs / Q000097:blood*; D008297:Male; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000097:blood*; D013548:Sweden; D055815:Young Adult
chemical_list: D002492:Central Nervous System Depressants; D013287:Illicit Drugs; D004364:Pharmaceutical Preparations; D000431:Ethanol