In post mortem cases, detection of drugs in blood is most relevant when it comes to acute cause of death. In some cases, however, it is also interesting to gain as much information as possible regarding the deceased's use of drugs in the period before death. The aim of this study was to analyse hair samples of post mortem cases, to determine how much complementary information these analyses add in addition to the traditional analysis in blood.

Forensic autopsy cases in which intake of drugs was suspected were included in the study. Post mortem blood collected from a ligated femoral vein was analysed for a large number of psychoactive medicinal drugs using LC-MS or UPLC-MS/MS methods, fully validated for routine use at the Norwegian Institute of Public Health. In addition, post mortem hair samples from the same corpses were collected by cutting as close as possible to the scalp. The 3cm proximal hair segment was submitted for analysis. Analyses for psychoactive medicinal drugs were performed using a fully validated LC-MS/MS method. Drugs not included in both the blood and hair methods were excluded.

Nineteen post mortem cases were included. Table 1 show the psychoactive drugs detected in hair in each individual case. Drugs underlined were not detected in blood. In total, hair analyses gave information of use of drugs not detected in blood in 12 of the 19 cases (63 %). In these cases, additional use of 1–3 drugs was revealed.
Table 1 Psychoactive, medicinal drugs detected in hair in 19 post mortem cases. Drugs underlined were not detected in blood.Case numberPsychoactive drugs detected in hair1amitryptiline, nortryptiline, venlafaxine, citalopram, diazepam, zolpidem2none3quetiapine, diazepam, alprazolam4amitryptiline, nortryptiline, mirtazapine, citalopram, levomepromazine, haloperidol, quetiapine, oxazepam, zopiclone5trimipramine, zopiclone, desemthyldiazepam6desemthyldiazepam7pregabalin, amitryptiline, nortryptiline, diazepam8sertraline9haloperidol, fluvoxamine, zuclopentixol, oxazepam, zolpidem10nitrazepam, diazepam, alprazolam11diazepam12haloperidol, diazepam, desmethyldiazepam, zopiclone13perfenazine, diazepam14diazepam15trimipramine16risperidone, diazepam17diazepam, zopiclone18mirtazapine, imipramine, quetiapine, oxazepam, zopiclone19desvenlafaxine, oxazepam, zolpidem

Post mortem hair analysis adds valuable information about the use of medicinal drugs in the period before death. In a large proportion of cases, use of drugs in addition to those detected in blood, is confirmed