Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022

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dc.contributor.advisorDavies, Bronwen
dc.contributor.advisordu Toit, Chanté
dc.contributor.authorMunarini, Murendwa Success
dc.date.accessioned2025-09-15T13:17:52Z
dc.date.available2025-09-15T13:17:52Z
dc.date.issued2025
dc.date.updated2025-09-15T13:15:59Z
dc.description.abstractBackground: Unnatural deaths, which include homicides, suicides, and accidental deaths, often require toxicological analysis to assist with determining the cause of death. In 2022, the Forensic Toxicology Unit within the Western Cape Forensic Pathology Service piloted a targeted drugs analysis at Salt River Mortuary in Cape Town. This permitted an assessment of commonly misused drugs in suspected unnatural and/or unexplained deaths, which was previously not feasible, given the backlogs of National toxicological analyses. Aim: To assess toxicological findings of a targeted LC-MS/MS drugs of misuse panel in suspected unnatural death cases in the west metropole of Cape Town, Western Cape. Methods: A retrospective, descriptive study was conducted on all cases for which specimens were submitted to the Forensic Toxicology Unit between 1 January 2022 and 31 December 2022 for a targeted drugs analysis of 31 analytes using LC-MS/MS. Blood alcohol and toxicology results from the National Forensic Chemistry Laboratory were also compared within the cohort. Results: The Forensic Toxicology Unit analysis was requested in 735 cases, with qualitative (n=723, 98.4%) and quantitative (n=108, 14.7%) analyses performed. Drugs were detected in 382 (52.8%) of the 723 cases analysed. The most frequently detected drugs were acetaminophen (24.8%), methamphetamine (17.6%), amphetamine (14.4%), methaqualone (13.8%) and THC-COOH (12.9%). Blood alcohol analysis was requested from the National Forensic Chemistry Laboratory in 541 cases (73.6%), and ethanol was detected (≥0.01 g/100mL) in 138 (25.6%) of these cases, with a mean positive BAC of 0.14 ± 0.02 g/100 mL (range: 0.01-0.54 g/100 mL). Conclusion: This study revealed that commonly misused drugs were frequently present in suspected unnatural and/or unexplained deaths admitted to Salt River Mortuary in Cape Town. However, given that only a portion of cases were submitted for analysis, and that the panel was limited in scope, it does not represent the full landscape of drug exposure in unnatural deaths. Nonetheless, this study represents the first comprehensive data on drugs (other than alcohol) in post-mortem toxicology casework in South Africa, using validated methodology.
dc.identifier.apacitationMunarini, M. S. (2025). <i>Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022</i>. (). Universiy of Cape Town ,Faculty of Health Sciences ,Department of Pathology. Retrieved from http://hdl.handle.net/11427/41813en_ZA
dc.identifier.chicagocitationMunarini, Murendwa Success. <i>"Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022."</i> ., Universiy of Cape Town ,Faculty of Health Sciences ,Department of Pathology, 2025. http://hdl.handle.net/11427/41813en_ZA
dc.identifier.citationMunarini, M.S. 2025. Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022. . Universiy of Cape Town ,Faculty of Health Sciences ,Department of Pathology. http://hdl.handle.net/11427/41813en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Munarini, Murendwa Success AB - Background: Unnatural deaths, which include homicides, suicides, and accidental deaths, often require toxicological analysis to assist with determining the cause of death. In 2022, the Forensic Toxicology Unit within the Western Cape Forensic Pathology Service piloted a targeted drugs analysis at Salt River Mortuary in Cape Town. This permitted an assessment of commonly misused drugs in suspected unnatural and/or unexplained deaths, which was previously not feasible, given the backlogs of National toxicological analyses. Aim: To assess toxicological findings of a targeted LC-MS/MS drugs of misuse panel in suspected unnatural death cases in the west metropole of Cape Town, Western Cape. Methods: A retrospective, descriptive study was conducted on all cases for which specimens were submitted to the Forensic Toxicology Unit between 1 January 2022 and 31 December 2022 for a targeted drugs analysis of 31 analytes using LC-MS/MS. Blood alcohol and toxicology results from the National Forensic Chemistry Laboratory were also compared within the cohort. Results: The Forensic Toxicology Unit analysis was requested in 735 cases, with qualitative (n=723, 98.4%) and quantitative (n=108, 14.7%) analyses performed. Drugs were detected in 382 (52.8%) of the 723 cases analysed. The most frequently detected drugs were acetaminophen (24.8%), methamphetamine (17.6%), amphetamine (14.4%), methaqualone (13.8%) and THC-COOH (12.9%). Blood alcohol analysis was requested from the National Forensic Chemistry Laboratory in 541 cases (73.6%), and ethanol was detected (≥0.01 g/100mL) in 138 (25.6%) of these cases, with a mean positive BAC of 0.14 ± 0.02 g/100 mL (range: 0.01-0.54 g/100 mL). Conclusion: This study revealed that commonly misused drugs were frequently present in suspected unnatural and/or unexplained deaths admitted to Salt River Mortuary in Cape Town. However, given that only a portion of cases were submitted for analysis, and that the panel was limited in scope, it does not represent the full landscape of drug exposure in unnatural deaths. Nonetheless, this study represents the first comprehensive data on drugs (other than alcohol) in post-mortem toxicology casework in South Africa, using validated methodology. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - Unnatural deaths KW - homicides KW - suicides KW - accidental deaths KW - Forensic Toxicology KW - the Western Cape Forensic Pathology Service LK - https://open.uct.ac.za PB - Universiy of Cape Town PY - 2025 T1 - Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022 TI - Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022 UR - http://hdl.handle.net/11427/41813 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/41813
dc.identifier.vancouvercitationMunarini MS. Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022. []. Universiy of Cape Town ,Faculty of Health Sciences ,Department of Pathology, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/41813en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Pathology
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversiy of Cape Town
dc.subjectUnnatural deaths
dc.subjecthomicides
dc.subjectsuicides
dc.subjectaccidental deaths
dc.subjectForensic Toxicology
dc.subjectthe Western Cape Forensic Pathology Service
dc.titleInvestigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMPhil
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