heroin and Airway-Obstruction

This is a collaborative piece of work undertaken between the PCA and a Principal FME. The study is based on 16 cases of internal drug concealment drawn from 43 drug-related deaths in custody in England and Wales between 1997 and 2002. These data are supplemented by three case studies from a county force involving non-fatal drug concealment to illustrate practical custody issues. The majority of the 16 deaths were white (n = 12) and male (n = 13) with a mean age of 34 years. In half of the cases, the deceased was known or believed to have concealed drugs orally at the point of initial contact with police. In 4/16 cases, the individual first showed signs of medical distress in a public place, a further 4 collapsed on arrival at the police station and two more detainees were subsequently found collapsed in their cell. Drug toxicity was the most common cause of death (10/16). In 5 cases death was caused by airway obstruction by swallowed packages. Both cocaine (14/16) and cannabis (8/16) traces were found in post-mortem samples. The report emphasises the need for a safety first approach.

Topics: Adolescent; Adult; Airway Obstruction; Amphetamines; Cannabinoids; Cocaine; Crime; Deglutition; Dopamine Uptake Inhibitors; Drug Packaging; Female; Foreign Bodies; Forensic Medicine; Hallucinogens; Heroin; Humans; Hypoxia; Male; Middle Aged; N-Methyl-3,4-methylenedioxyamphetamine; Narcotics; Police; Prisoners; Substance-Related Disorders

A 28-year-old healthy man collapsed while being arrested by the police for alleged possession of heroin and was found dead on admission to the hospital. Autopsy revealed complete occlusion of the laryngeal opening by a cellophane bag containing 24 packets of heroin powder.

Topics: Adult; Airway Obstruction; Fatal Outcome; Foreign Bodies; Forensic Medicine; Heroin; Humans; Illicit Drugs; Larynx; Law Enforcement; Male; Product Packaging

Topics: Administration, Inhalation; Adult; Airway Obstruction; Heroin; Humans; Male; Prospective Studies; Substance-Related Disorders; Time Factors

Topics: Adult; Airway Obstruction; Crime; Death, Sudden; Heroin; Humans; Male

Topics: Acidosis; Acidosis, Respiratory; Airway Obstruction; Carbon Dioxide; Heroin; Humans; Hypercapnia; Hypothyroidism; Hypoventilation; Hypoxia; Lung Diseases, Obstructive; Neuromuscular Diseases; Oxygen; Pulmonary Alveoli; Pulmonary Circulation; Pulmonary Edema; Pulmonary Embolism; Respiration; Respiratory Insufficiency; Ventilation-Perfusion Ratio; Work of Breathing