From Substance Use Disorders in Life to Autopsy Findings: A Combined Case-Record and Medico-Legal Study

Louise Brådvik, Peter Löwenhielm, Arne Frank, Mats Berglund

Research output: Contribution to journalArticlepeer-review


Objectives: Several studies have shown mortality and suicide risk in substance use disorders, and autopsy findings with respect to the used substances. However, there seems to be a gap in the knowledge about substances misused in life and at death at the within-person level. Methods: All consecutive, autopsied patients during 1993 to 1997, who had been in contact with the Addiction Centre in Malmö from 1968, were investigated (365 subjects). Drug misuse in the long-term course noted in case records was related to autopsy findings. Self-inflicted death (suicide/undetermined suicide/accidental overdose) was compared with natural death. Results: Benzodiazepine misuse was associated with a high risk of autopsy findings of the substance in suicide and death of undetermined intent. It was also associated among non-misusers, but less so. An alcohol level above 1‰ was found more often in self-inflicted death. Prescription opioids at autopsy were mainly found in self-inflicted death among non-misusers. Heroin misuse was related to overdose. Central nervous system stimulants (CNS-S) and cannabis were rarely found in self-inflicted death among previous misusers. The overlap between depression in life and antidepressants at death was low. Conclusions: Benzodiazepines and alcohol seem to disinhibit suicidal tendencies. Suicide risk among users of cannabis and CNS-S may be related to other risk factors than acute use. Implications for suicide prevention are discussed.

Original languageEnglish
Article number801
JournalInternational Journal of Environmental Research and Public Health
Issue number5
Publication statusPublished - 2019 Mar 5

Subject classification (UKÄ)

  • Substance Abuse

Free keywords

  • autopsy findings
  • case records
  • depression
  • substance use disorders
  • suicide risk


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