Fatal injections of heroin. Interpretation of toxicological findings in multiple specimens

We report two fatalities due to injection of heroin. The first case was wit nessed but during the early phase of the police investigation the question was raised whether the injection was self-administered. Multiple samples we re collected from different sites and analysed in order to establish drug d istribution and to determine the site of injection. Fresh injection marks w ere found in both antecubital fossae but histological examination failed to settle which one was the last. However, toxicological analysis of the tiss ues at the injection sites indicated that the injection in the right arm wa s the last one. This was consistent with the suspicion that the victim was given the injection by another person although probably in agreement with t he deceased. In the second case, a similar toxicological procedure was used . This fatality was not witnessed, however ample evidence indicated that it was an isolated event in a former intravenous heroin addict and there was only one fresh injection mark. Even in this case, the concentration of morp hine was much higher in the tissue sample from the injection mark than in a ny of the blood samples.