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Drugs and violent death: comparative toxicology of homicide and non-substance toxicity suicide victims

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To determine the comparative toxicology of death by homicide and suicide by means other than substance toxicity. Design 

Cross-sectional (autopsy reports). Setting 

Sydney, Australia. Cases 

A total of 1723 cases of violent death were identified, comprising 478 homicide (HOM) cases and 1245 non-substance toxicity suicide (SUI) cases. Findings 

Substances were detected in 65.5% of cases, and multiple substances in 25.8%, with no group differences. Illicit drugs were detected in 23.9% of cases, and multiple illicit in 5.3%. HOM cases were significantly more likely to have an illicit drug [odds ratio (OR) 2.09] and multiple illicits (OR 2.94), detected, HOM cases being more likely to have cannabis (OR 2.39), opioids (OR 1.53) and psychostimulants (OR 1.59) present. HOM cases were, however, significantly less likely to have benzodiazepines (OR 0.53), antidepressants (OR 0.22) and antipsychotics (OR 0.23) present. Alcohol was present in 39.6% of cases (median blood alcohol concentration = 0.12), with no group difference in prevalence. Conclusions 

The role drugs play in premature death extends far beyond overdose and disease, with illicit drugs associated strongly with homicide.

Keywords: Dependence; homicide; mortality; suicide; toxicology; violence

Document Type: Research Article


Affiliations: 1: Department of Forensic Medicine, Sydney South West Area Health Service, School of Medical Sciences, University of New South Wales and Department of Pathology, University of Sydney, NSW, Australia 2: National Drug and Alcohol Research Centre, University of New South Wales, Australia and

Publication date: June 1, 2009

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