Psychoactive substances in a general forensic autopsy population: prevalence and associations with cause and manner of death

Abstract

International audienceThis study investigated the prevalence of opioid-related deaths within a general forensic population. Conducted as a prospective, single-center, observational study, it included all subjects autopsied in forensic medicine in the Auvergne region (France). The primary objective was to assess the prevalence of opioid-related deaths in forensic cases, with secondary objectives including evaluating the prevalence of non-opioid psychoactive substances, screening blood alcohol levels, and profiling victims.Among 422 subjects who died from unnatural causes, the leading causes of death were suicide (51.7%) and accidents (39.8%). Opioids were detected in 24.2% of individuals, but directly involved in only 17.6% of those cases. Substances, including alcohol, were found in more than two-thirds of deaths (71.2%). Three distinct victim profiles were identified: middle-aged and elderly males dying by violent suicide; young males dying by fatal traffic accidents, often under the influence of alcohol and drugs of abuse; and young males dying by homicides, frequently under the influence of alcohol, opioids and toxic or lethal drugs.The study provides data on the prevalence and role of opioids, alcohol, and non-opioid psychoactive substances in forensic deaths. While opioids were directly implicated in a limited number of cases, the study highlights the significant presence of alcohol and other non-opioid psychoactive substances in unnatural deaths. These findings, suggest that further research with a larger study area and more cases would be beneficial