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

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@article{e39e9506a8d849f0b6f9274a882a519f,
title = "From Substance Use Disorders in Life to Autopsy Findings: A Combined Case-Record and Medico-Legal Study",
abstract = "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 Malm{\"o} 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.",
keywords = "autopsy findings, case records, depression, substance use disorders, suicide risk",
author = "Louise Br{\aa}dvik and Peter L{\"o}wenhielm and Arne Frank and Mats Berglund",
year = "2019",
month = "3",
day = "5",
doi = "10.3390/ijerph16050801",
language = "English",
volume = "16",
journal = "International Journal of Environmental Research and Public Health",
issn = "1660-4601",
publisher = "Multidisciplinary Digital Publishing Institute",
number = "5",

}