Methamphetamine-related fatalities in forensic autopsy during 5 years in the southern half of Osaka city and surrounding areas

To outline the recent features of methamphetainine-related fatalities from the medico-legal point of view, a retrospective investigation of forensic a utopsy cases involving methamphetamine during a 5-year period (1994-1998) i n the southern half of Osaka city and surrounding areas (about 1.57 million population) was undertaken. Among 646 autopsy cases, methamphetamine was d etected in 15 victims (nine males, six females; 16-71 years of age; most fr equently in males in their thirties). Primary scenes of fatal events were c oncentrated in the middle of the city. About half of them were transfered f rom emergency medical centers (survival time, up to 30 h). The cause rind m anner of death were: methamphetamine poisoning (n=4), homicide (n=4), accid ental falls and aspiration from drug abuse (n=4), fire death (n=1), myocard ial infarction (n=1), and cerebral hemorrhage (n=1) under drug influence. U sually injection scars and fresh puncture sites were found. Blood methamphe tamine concentrations were 2.29-17.05 mu mol/dl in the fatal poisoning, 0.4 4-3.80 mu mol/dl in deaths from other extrinsic causes (trauma), and 1.35-2 .17 mu mol/dl in cardio- and cerebrovascular strokes. Common complications were cardiomyopathy, cerebral perivasculitis and liver cirrhosis/interstiti al hepatitis. Fatal and nonfatal methamphetamine poisonings are separately dealt with by the administrative medical examiner's office and in emergency medical centers. Tightly cooperative approaches of clinical and medico-leg al experts are required for the effective social and medical management of drug abuse. (C) 2000 Elsevier Science Ireland Ltd. All rights: reserved.