A PCP overdose death in Northern Virginia

Phencyclidine (PCP), a Schedule II dissociative anesthetic, is no longer prescribed. Recreational use of PCP still exists, often localized to certain metropolitan areas in the United States, including the Baltimore-Washington, D.C. corridor. PCP was detected in 3.07% of the Driving Under the Influence of Drugs (DUID) cases in Virginia and 0.55% of medical examiner cases from 2020 to 2024. For the northern region of Virginia, PCP was detected in 8.08% of the DUID cases and 1.76% of the medical examiner cases from 2020 to 2024. The purpose of this study was to determine the concentration of PCP in a postmortem overdose case where the concentration was reported as present greater than 2000 ng/mL. The subject was a 47-year-old individual who had a history of PCP use. An Agilent Technologies 7890A/5975C Gas Chromatograph-Mass Spectrometer (GC-MS) operated in selected ion-monitoring (SIM) mode was used after PCP was extracted in triplicate using a liquid/liquid alkaline extraction. The mean PCP concentration of the three replicates was approximately 5400 ng/mL. The concentration of PCP in this case is at a much higher concentration than other PCP cases from 2020 to 2024 in Virginia and consistent with literature results for PCP fatalities. After postmortem examination ("foam cone" with no trauma to the body) and review of toxicology results (negative in all analyses except PCP), the cause of death was determined to be "PCP Intoxication." This case provides detailed information on behavior and autopsy findings for a PCP overdose death, where death was due to PCP intoxication as opposed to intoxicated behavior.