Drug detection at autopsy: a prospective study of 247 cases

Comprehensive toxicology analyses using gas chromatography of blood for alcohol and acidic, basic, and neutral drugs were performed on 247 randomly selected medical examiner cases. Drugs or alcohol or both were found in 54% of this group. When considered by manner of death (natural, accident, homicide, and suicide), each of the groups had incidences of positive findings of 46 to 63%. Selection of cases for toxicologic study on the basis of manner of death does not seem to be feasible. It is the authors' opinion that comprehensive toxicology evaluation for drugs should be done on virtually all medical examiner cases. This approach ensures a thorough and complete evaluation in all cases. In addition, a comprehensive toxicology study will provide information in the event that questions concerning the absence or presence of drugs arise at some later date.