A common occurrence in the drug culture is the death of a user. Investigation of a narcotic death is divided into three (3) phases: the SCENE investigation, the MEDICAL investigation, and the TOXICOLOGICAL investigation.
An officer involved in such a case should determine the manner of death, that is, whether homicide, suicide or accidental. All of the factors and elements of the scene must be accurately and completely recorded. This will assist the medical examiner in determining the cause of death.
Physiological Effect of Narcotic Ingestion
The ingestion of narcotics or dangerous drugs poisons the body. This is poisoning effect will leads to a paralysis of the respiratory center or cause heart failure. This, the, will deny the body a sufficient amount of oxygen.
Evident or visible signs, which remain after death, often accompany the effects of a particular drug on the human body for the trained observe. These signs are result of symptoms experienced by the victim prior to death. Following is a partial listing of the more dangerous drugs, the minimum lethal dose, symptoms and cause of death:
Poison Symptoms/Cause of Death
Codeine Nausea, dizziness, Constipation, Respiratory failure Heroin &
Morphine Sweating, loss of appetite, nausea (Vomiting),
Constipation, itching, thirst, cyanosis, respiratory failure Barbiturates lower body temperature, cyanosis, cold extremities skin rash,
constipation, respiratory arrest of pneumonia Cocaine nausea, vomiting, chills, sweating, thirst, convulsions,
circulatory and respiratory failure
Amphetamine Chills, sweating, diarrhea, constipation, nausea, vomiting, cramps, thirst, convulsions, petechial hemorrhages
The Scene of Death
During investigation of the scene, you should recognize and relate seemingly insignificant items or material, which would justify a conclusion of narcotic involvement. The following are just some of such items:
1. Paraphernalia (or “works”) – Tools or implements used in administering narcotics. These may include the obvious syringe and needle, tourniquet, spoon or bottle top “cookies” and tinfoil packet. Also included are small balls of cotton, capsules and envelopes, and a book of matches.
2. Narcotic Medication – Laudanum, paregoric, codeine cough syrup, all utilized as “carryovers” until the next fix.
3. Maalox –Milk of Magnesia – Medication used to relieve nausea, vomiting, constipation, cramps or diarrhea.
4. Absence of Nutritional Food – Loss of appetite is a symptom of poisoning. Presence of candy or soft drinks indicates low insulin count.
5. Body Fluids – Presence of urine, feces, mucus or vomitus on the scene may be evidence of the body attempting to rid itself of poisoned substance.
6. Clothing or Bed Linens – which may be sweat-stained or soaking wet from the victim having hot and cold flashes, should be collected and analyzed.
7. Lack of Ordinary Cleanliness – Dependent user is not concerned in most cases with the environment or health, and this is shown by a neglect of both.
8. Wet Body – Evidence of body being immersed in tub or shower, or having ice cubes placed in underclothes or in private parts. It is a common mistake uses make in thinking this helps in overdose cases. Salt water may also be injected into the victim. Hospitals use Narcan as antidote.
9. Nylon Stoking – Stretched over a hanger used as sieve.
10. Playing Card – with the powder, may have been used to “smack” (cut) heroin. The card is usually on top of a record album or similar.
11. Merchandise – Small items which are easily carried and disposed of after, being stolen-radios, watches, portable TVs, radios, etc.
The Body Signs
1. Cyanosis – bluish discoloration of the face and /or fingernails due to insufficient oxygenation of the blood caused by increase in carbon dioxide in the body.
2. Petechial Hemorrhages – Pinpoint spots of discoloration resulting from capability ruptures due to pressure and generally observed in the eyes, eyelids, behind the ears and internally.
3. Form or Froth – Observed in mouth and nose, may be white or pinkish and caused by fluids entering the air passages.
4. Hematoma – A localized swelling on any par to the body caused by bleeding beneath the surface of the skin.
This is caused by “skin popping” rather that vein injections.
5. Needle marks/tracks – Visual evidence of repeated intravenous injections. The tracks will follow a vein (exception “skin popping”) and result in a dark discoloration and eventual collapse of the vein.
6. Scar – Skin imperfection caused by the victim in removing needle mark scabs, added to uncleanness of the victim.
7. Rash/scratched Skin – External body signs of morphine or heroin poisoning.
8. Asphyxia- When it is the cause the death, it is often accompanied by external body changes. These changes, visible to the naked eye, are not restricted to narcotic-related deaths and may be found in other asphyxia deaths, such as hearth attack, drowning, hanging, etc. They must be noted, photographed and reported to the pathologist during the pre-autopsy interview.
Victim’s History
Historical date on the victim would include his criminal record (local, national and international and international); medical record (of a private doctor, hospitals, clinics, etc. and any mental treatment or attempts at suicide); social (relatives, friends, neighbors, co-workers); marital (past or present); and financial records.
When interviewing users or person possibly involved in narcotics traffic, you should use straight language rather than attempt street talk because slang constantly changes. You must determine the extent of decedent’s addiction, his familiarity with other drugs, whether he had a steady source of the drugs or continuously shopped around, and other matters relative to his personal history.
Medical Phase
This is the most important stage of the narcotics death investigation. Since the pathologist will rarely be able to examine the body at the death scene, you should note every detail, which may be of medico-legal importance and make a complete report on this.
You should attend the autopsy yourself. Make sure that the following specimens are submitted for narcotics, alcohol or other foreign matter. Heroin is quickly changed to morphine after entering the body, and clears the blood in approximately ½ hour remains in the urine about 24 hours and in the bile for ¾ days.
CRIMINAL INVESTIGATIVE REPORTING