PATTERNS AND PREDICTORS OF DEATH IN METHAMPHETAMINE TOXICITY: A COMPREHENSIVE FORENSIC ANALYSIS
Main Article Content
Keywords
Methamphetamine, Forensic Toxicology, Autopsy, Drug-related Death, GC-MS, Pakistan, Histopathology, Sudden Death
Abstract
Background: Methamphetamine is a potent psychostimulant associated with increasing mortality worldwide. In Pakistan, forensic data on methamphetamine-associated deaths remain scarce, limiting insight into the toxicological and pathological characteristics of such cases.
Objective: To analyze the clinical, toxicological, and autopsy patterns of methamphetamine-related fatalities and compare brought-in-dead and hospital death cases.
Methodology: A descriptive cross-sectional study was conducted from January 2022 to April 2023. Data was collected from medicolegal section of Department of Forensic Medicine and Toxicology, LUMHS, Jamshoro. Preliminary review of 29 methamphetamine-associated deaths were initiated at the Department of Forensic Medicine, LUMHS Jamshoro. Further data analysis, interpretation, and manuscript preparation were completed at the Department of Forensic Medicine, HBS Medical and Dental College, Islamabad. A total of 29 cases were evaluated: 11 brought-in-dead and 18 hospital deaths. Complete autopsies, GC-MS toxicology, histopathology, and retrospective clinical or circumstantial data were analyzed. Inferential statistics were applied to assess differences between groups.
Results: All cases tested positive for methamphetamine. High blood methamphetamine levels (>0.5 mg/L) were more common in brought-in-dead cases (72.7%) than hospital deaths (33.3%, p = 0.094). Pulmonary congestion (86.2%) and cerebral edema (75.9%) were frequent gross findings. Histopathology revealed alveolar edema (82.8%), neuronal damage (75.9%), and renal injury (62.1%). No statistically significant differences were found in age, gender, or organ pathology between the two groups.
Conclusion: Methamphetamine-associated deaths involve widespread multi-organ damage, with high blood levels more frequently observed in sudden, unattended fatalities. Comprehensive autopsy and toxicological analysis are vital for accurate cause-of-death determination in such cases.
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Dr. Muhammad Shafay
Assistant Professor, Department of Forensic Medicine, HBS Medical and Dental College, Islamabad, Pakistan.
Dr. Muhammad Arif
Associate Professor, , Department of Forensic Medicine, Rawal Institute of Health Sciences, Islamabad, Pakistan.
Dr. Sohail Rasool
Associate Professor, Department of Forensic Medicine, Mohammad College of Medicine, Peshawar, Pakistan.
Dr. Syeda Hina Zehra
Senior Lecturer, Shifa College of Medicine, Islamabad, Pakistan.
Dr. Alia Sarfaraz
Assistant Professor, Department of Forensic Medicine, Islamabad Medical and Dental College, Islamabad, Pakistan
Dr. Filza Ali
Assistant Professor, Department of Forensic Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.