The Analysis of Heroin-Related Death in Taoyuan County,Taiwan,2008-2013

Drug abuse in Taiwan is becoming more severe in recent years, which often results in accidental or suicidal drug-related death. Among the diverse drugs, heroin is the one that most easily leads to death in accidental drug overdose. This research collects heroin death cases from 2008 to 2013 in Tao-Yuan County of Taiwan and then analyzes the judicially testified data to find out the difference of these cases in terms of demography characteristic,toxicology examination results, post-mortem examination results and the associate evidence at the scene investigation. It turns out that there are 191 cases totally caused by heroin abuse within the 6 years. Most of the deceased are male (90.1%) and the prime of age is 25-44 (79.6%); half of the deceased are unmarried (50.3%); exconvict history takes up 91.6%; the place is mostly indoor(74.9%),which demonstrates the deceased took convenience and comfort of episode place into consideration. Abusers are most easily died from misuse amount because of reduced tolerance (23.8%) within 14 days released from the drug treatment institution. Applying tools could be found in the scene (50.8%); suicide note (60%) is an important point in deciding the manner of death. There are old needle tract (28.3%) and fresh needle mark (61.8%) in the bodies. Combined drug use are found (77%) which alcohol is the most common(31.7%) and benzodiazepines is the second (21.3%). Main cause of death are simple toxicogenic shock or combined respiratory failure; most of them are accidental death (82.2%); morphine concentration in the blood is obviously related to the manner of death, average morphine concentration in blood is 0.76μg/ml, which has reached the lethal concentration 0.2μg/ml and the concentrations are over the index in 89.6% of those cases. Urine collected through post mortem examination has relatively high 6-monoacetylmorphine positive detection rate (71.8%), which is important in judging whether the deceased is dying from heroin abuse or not. Forensic autopsy rate of heroin abuse is 20.4% and how to increase the autopsy rate in the future which may provide correct cause or manner of death even the positive detection rate of combined drug use . This research has the potential becoming the future reference or experience for the detective officers in investigating heroin abuse death cases and it also hopes to help related legal drug treatment departments and medical rehabilitation organizations by providing risk factors that cause the death, thus they can have formulated anti-drug policy and formulate lessons to lower the rate of heroin abuse death .