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Forensic Sci Int. 2016 Mar;260:31-39. doi: 10.1016/j.forsciint.2015.12.046. Epub 2016 Jan 7.

Synthetic cannabinoid drug use as a cause or contributory cause of death.

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NMS Labs, 3701 Welsh Rd, Willow Grove, PA, United States. Electronic address:
City and County of Denver, 660 Bannock Street, Denver, CO, United States.
Cuyahoga County Regional Forensic Science Laboratory, 11001 Cedar Avenue, Cleveland, OH, United States.
Office of the Chief Medical Examiner, 900W. Baltimore Street, Baltimore, MD, United States.
SUNY Upstate Medical University, Syracuse, NY, United States.
Department of Laboratory Medicine, School of Medicine, University of California, San Francisco, United States.
San Diego County Medical Examiner's Department, San Diego, CA, United States.
Onondaga County Medical Examiner's Office, 100 Elizabeth Blackwell Street, Syracuse, NY, United States.
Medical University of South Carolina, 181 Ashley Avenue MSC 908, Charleston, SC, United States.
Oklahoma Office of the Chief Medical Examiner, 1115 West 17th Street, Tulsa, OK, United States.
Coroner's Offices, Chester and Montgomery Counties, PA, United States.
NMS Labs, 3701 Welsh Rd, Willow Grove, PA, United States.


Adverse effects associated with synthetic cannabinoid use include agitation, psychosis, seizures and cardiovascular effects, all which may result in a lethal outcome. We report the collection of data from 25 medical examiner and coroner cases where the presence of synthetic cannabinoids was analytically determined. Participating offices provided case history, investigative and relevant autopsy findings and toxicology results along with the cause and manner of death determination. This information, with the agency and cause and manner of death determinations blinded, was sent to participants. Participants offered their opinions regarding the likely contribution of the toxicology findings to cause and manner of death. The results show that some deaths are being attributed to synthetic cannabinoids, with the highest risk areas being behavioral toxicity resulting in excited delirium, trauma or accidents and as contributing factors in subjects with pre-existing cardiopulmonary disease. While insufficient information exists to correlate blood synthetic cannabinoid concentrations to effect, in the absence of other reasonable causes, the drugs should be considered as a cause or contributory cause of death based on history and circumstances with supporting toxicological data.


Cause and manner of death; Postmortem; Synthetic cannabinoids; Toxicology

[Indexed for MEDLINE]

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