title: Clinical and forensic signs related to opioids abuse.
abstract: For a good performance in Clinical and Forensic Toxicology it is important to be aware of the biological and non-biological signs and symptoms related to xenobiotic exposure. This manuscript highlights and analyzes clinical and forensic imaging related to opioids abuse critically. Particularly, respiratory depression, track marks and hemorrhages, skin "popping", practices of phlebotomy, tissue necrosis and ulceration, dermatitis, tongue hyperpigmentation, "coma blisters", intra-arterial administration, candidiasis, wounds associated with anthrax or clostridium contaminated heroin, desomorphine related lesions and characteristic non-biological evidences are some commonly reported findings in opioids abuse, which will be discussed. For this purpose, clinical and forensic cases from our database (National Institute of Legal Medicine and Forensic Sciences, North Branch, Portugal), in addition to literature data, are reviewed.
authors.affiliation: Department of Legal Medicine and Forensic Sciences, University of Porto, Jardim Carrilho Videira, Porto, Portugal. ricardinis@sapo.pt
authors.forename: Ricardo Jorge
authors.initials: RJ
authors.lastname: Dinis-Oliveira
authors.forename: Felix
authors.initials: F
authors.lastname: Carvalho
authors.forename: Roxana
authors.initials: R
authors.lastname: Moreira
authors.forename: Jose Alberto
authors.initials: JA
authors.lastname: Duarte
authors.forename: Jorge Brandao
authors.initials: JB
authors.lastname: Proenca
authors.forename: Agostinho
authors.initials: A
authors.lastname: Santos
authors.forename: Teresa
authors.initials: T
authors.lastname: Magalhaes
mesh_terms: D004340:Drug Contamination; D053593:Forensic Toxicology / Q000379:methods*; D006556:Heroin Dependence / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D009293:Opioid-Related Disorders / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D015813:Substance Abuse Detection / Q000379:methods*