Abstract

The problem of drug abuse in America encompasses all ages, economic, and ethnic groups. The Office of the Chief Medical Examiner (OCME) has recorded a continuous increase in drug abuse deaths in Maryland over the past seven years. This report focuses on the epidemiological characteristics and pathological findings of victims of fatal drug abuse in Maryland investigated by the OCME in 1992 and 1993.

A retrospective study of OCME cases in 1992 and 1993 yielded a total of 605 deaths caused by drugs of abuse. 426 deaths were the result of narcotic drug use, 66 deaths due to cocaine, 102 deaths involved both narcotics and cocaine, 6 deaths were due to phencyclidine (PCP) and 5 involved both PCP and narcotic drugs. Drug abuse deaths most often involved individuals who were male (86%) and black (64%). Their ages ranged from 15 to 68 years with the majority (58%) of victims being in their 30's. Of the 605 drug deaths, 393 (65%) had a known history of drug abuse. 279 (46%) exhibited needle tracks, of which only 94 (16%) had identifiable fresh needle puncture marks. Drug paraphernalia (needles, syringes, etc.) was found at the scene in 22% of the cases. Twenty-nine (4.8%) cases showed complications of drug abuse which included pneumonia, endocarditis or myocarditis, pulmonary embolism, AIDS and intracerebral hemorrhage, 87 (14.4%) were positive for HIV antibodies, an incidence much higher than that identified in our general autopsy population (2.6%).

Drugs of abuse were also found in a significant portion of the homicides examined at this office in 1992 and 1993. 323 of the 1265 homicide victims (25%) showed evidence of some form of illicit drug activity.

References

1.
Annual Data
.
Data from the Drug Abuse Warning Network
.
Rockville, MD
,
National Institute on Drug Abuse
. Annual Medical Examiner Data 1991, Statistical Series I, Number
11-B
,
1992
;
47
-
68
.
2.
Battista
H J
,
Rossler
H
,
Haller
R
,
Kohler
H
,
Riemer
Y
,
Henn
R
,
Hinterhuber
,
H
.
A survey of drug deaths in western Austria
.
Forensic Sci Int
1994
;
62
(
1,2
):
141
-
6
.
3.
Suwanwela
C
,
Poschyachinda
V
.
Drug abuse in Asia
.
Bull Narc
1986
;
38
(
1,2
):
41
-
53
.
4.
Gfroerer
J.
,
Brodsky
M
.
New Data Note Series-8. The incidence of illicit drug use in the United States, 1962–1989
,
Br J Addiction
1992
;
87
(
9
):
1345
-
51
.
5.
Kameron
D B
,
Pincus
H A
,
MacDonald
D I
.
Alcohol abuse, other drug abuse and mental disorders in medical practice
.
JAMA
1986
;
255
(
15
):
2054
-
7
.
6.
Harrison
L D
.
Trends in illicit drug use in the United States: conflicting results from national surveys
.
Int J Addictions
1992
;
27
(
7
):
817
-
47
.
7.
Kingery
P M
,
Pruitt
B E
,
Hurley
R S
.
Violence and illegal drug use among adolescents: evidence from the U.S. national adolescent student health survey
.
Int J Addictions
1992
;
27
(
12
):
1445
-
64
.
8.
Garriott
J C
.
Drug use among homicide victims
.
Am J Forensic Med Pathol
1993
;
14
(
3
):
234
-
7
.
9.
Nurco
D N
,
Hanlon
T A
,
Kinlock
T W
,
Duszynski
K R
.
The consistence of types of criminal behavior over pre-addiction, addiction, and non-addiction status periods
.
Comp Psych
1989
;
30
(
5
):
391
-
402
.
10.
Office of Intelligence, Drug Enforcement Administration, U.S. Department of Justice. Domestic Monitor Program, 1992 Annual Summary,
06
1993
.
11.
Agar
M H
,
Murdoch
R O
.
Investigation of recent trends in heroin use in Baltimore City
.
CESAR Special Topics Report
94-1;
University of Maryland at College Park
, CESAR FAX
1994
;
3
(5).
12.
Kleiman
M R
,
Caulkins
J P
.
Heroin policy for the next decade
.
Ann of the Am Acad Pol Soc Sci
1992
;
521
:
163
-
74
.
13.
University of Maryland at College Park
.
A weekly FAX from the Center for Substance Abuse Research
, CESAR FAX
1994
;
3
(
7
).
14.
French
J F
,
Safford
J
.
AIDS and intranasal heroin [letter]
.
Lancet
 0140-6736
1989
;
1
:1.
15.
Schottenfeld
R S
,
O'Malley
S
,
Abdul-Salaam
K
,
O'Conner
P G
.
Decline in intravenous drug use among treatment-seeking opiate users
.
J Substance Ab Treat
1993
;
10
(
1
):
5
-
10
.
16.
Cone
E J
,
Holicky
B A
,
Grant
T M
,
Darwin
W D
,
Goldberger
B A
.
Pharmacokinetics and pharmacodynamics of intranasal “snorted” heroin
.
J Anal Tox
1993
;
17
(
6
):
327
-
37
.
This content is only available via PDF.
You do not currently have access to this content.