Post-mortem toxicological analysis of hair in violent fatalities: an investigation into long-term drug exposure

Master Thesis


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Violence-related injuries are a major cause of mortality in the Western Cape (South Africa). Previous research has demonstrated an association between violent mortalities and drug use. Furthermore, long-term drug use has been shown to alter behaviour that may lead to violence. Hence, this study aimed to investigate the effect of long-term drug use on violence-related mortalities. Due to the drug retention properties of hair, it is the gold standard for demonstrating the historical pattern of drug use. Hair samples were collected from 92 violent death cases admitted to Salt River Mortuary (South Africa). A qualitative toxicological analysis was performed in 90 hair samples using a SCIEX X500R QTOF. Variables pertaining to the colour and length of the hairs were recorded. The majority of the hair samples were black (n=79), while others were black and white (n=5), greyish (n=3), light grey and reddish brown (n=1) and strong brown hair (n=1). Various toxicologically relevant substances were detected in 74 cases (82.2 %) in which a total of 54 different substances were detected in hair samples. Acetaminophen was the most prominent licit substance (47%) detected, followed by caffeine (18.9%) and diphenhydramine (12%). Methamphetamine was the most common illicit detected substance (54%), followed by methaqualone (43%). Segmented hair samples showed historical use in 81.2 % of cases. These results show that hair can be used as a supplementary sample during toxicological investigation in violent fatalities in the local context.