The Relationship of Drug Abuse to Unexplained Sudden Death.
Occasionally a young adult dies suddenly and unexpectedly and investigation by the medical examiner’s office reveals neither anatomical nor toxicologic cause for death. Often the only information suggestive of a possible cause of death is a history of drug abuse. We hypothesize that the individuals in these undetermined deaths, where neither anatomical nor toxicologic cause for death is found at autopsy, share a common history of drug abuse because drug abuse induces some change that persists after the drug is no longer detectable in the body. If our hypothesis is true, then this change, which is presumably at the molecular level, would increase the likelihood of sudden death. In an earlier study, we compared deaths that were undetermined in cause and manner with other deaths that were accidental. (1) In that study we showed that evidence of drug abuse was 4.2 times more common in the undetermined deaths than in the accidental deaths. We continue to investigate this hypothesis by conducting a retrospective case-control study comparing the case findings and history of drug abuse in deaths examined in our office that had an undetermined cause of death with a control group of living patients who presented to a hospital for cholecystectomy. Our purpose in this study was to evaluate the reproducibility of our previous study by determining whether drug abuse is more prevalent in individuals who died of undetermined causes than in a separate and distinct control group, namely, a sample of living patients evaluated at an indigent care hospital. MATERIALS AND METHODS