Polysubstances in Drug-Induced Deaths: A Case Report
Abstract:
Objectives: We present a recent case of lethal polysubstance intoxication that had been almost unreported due to the lack of interest in further investigation by the competent authorities. Results from post-mortem examination are discussed in terms of their relevance on drug-mortality surveillance system.
Methods: The autopsy of 40-year-old man was performed upon the coroner's request. Biological samples were col lected and analysed histologically and by toxicological procedures involving immunoassays and gas chromatogra phy–mass spectrometry (GC–MS). Ind addition, the samples of medications found next to the dead body were toxico logically analysed and compared with the result of tested biological samples.
Results: Severe cerebral and pulmonary oedema, as well as general congestion were detected, in the absence of any other pathological changes. Toxicological analysis of blood and urine revealed the presence of opioids (Buprenor phine, Methadone, Tramadol), antipsychotics (Clozapine), benzodiazepines (Diazepam), antidepressants (Mirtazap ine), and Pregabaline (antiepileptic, analgesic, anxiolytic).
Conclusion: The cause of death was attributed to an acute mixed intoxication by various substances. This case rep resents a continuation of the trend observed in the last few years in the Split-Dalmatian County and once again calls for improvements of the present monitoring and communication system in Croatia, which currently provides inade quate measurement of drug trends and lacks a timely response to drug-related dangers.
