Toward a risk-based autopsy framework: identifying pre-autopsy predictors of illicit substance use

Area of Science:

• Forensic Science
• Toxicology
• Public Health

Background:

• Early identification of substance use risk is crucial for forensic procedures and safety.
• Contextual and behavioral indicators at initial encounters inform risk assessment.

Purpose of the Study:

• Identify sociodemographic and external physical indicators predicting illicit substance use in postmortem cases.
• Inform risk-based triage models for toxicology and occupational safety.

Main Methods:

• Retrospective case series analysis at a metropolitan forensic autopsy unit.
• Systematic review and coding of demographic factors, external findings, and toxicology outcomes.

Main Results:

• Illicit substance use linked to male sex, young adults, injection marks, self-inflicted scars, and thematic tattoos.
• Cachexia showed a non-significant trend in substance users.
• Missing sociodemographic data indicated potential marginalization.

Conclusions:

• Pre-autopsy indicators aid early identification of substance use risk.
• Focused toxicological screening and biosafety precautions can be enhanced.
• Observation-based triage improves diagnostic yield and occupational protection in forensic settings.