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Cocaine detection in postmortem samples following therapeutic administration.

Kristen M Bailey¹, David J Clay, Myron A Gebhardt

¹Office of the Chief Medical Examiner, Charleston, West Virginia, USA. Kristen.M.Bailey@wv.gov

Journal of Analytical Toxicology

|October 31, 2009

Summary

Forensic toxicology must consider clinical cocaine use, not just illicit abuse. Medical record review is crucial for accurate cause of death determination when cocaine is detected.

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Area of Science:

Forensic Toxicology
Clinical Pharmacology

Background:

Cocaine is frequently detected in forensic toxicology, often presumed to be from illicit use.
However, cocaine has legitimate clinical applications as a local anesthetic and vasoconstrictor.

Observation:

A case report details a 54-year-old male who died post-injury.
Autopsy revealed cocaine and its metabolites in urine.
Surgical records confirmed clinical cocaine administration for nasal fracture repair on the day of death.

Findings:

The presence of cocaine and metabolites in forensic samples does not automatically indicate illicit drug abuse.
Thorough investigation, including medical record review, is essential.

Implications:

Misinterpretation of cocaine presence can lead to incorrect cause and manner of death rulings.
This case highlights the importance of distinguishing clinical use from illicit abuse in forensic investigations.