Determining Youth Intentional Fatal Drug Intoxication: The Case for a Psychological Autopsy to Complement the Medical Examiner's Report. Issue 1 (2nd January 2020)

• Record Type: Journal Article
• Authors: Kaminer, Yifrah; Burke, Rebecca; Gill, James
• Is Part Of: Journal of child & adolescent substance abuse. Volume 29:Issue 1(2020)
• Page Start: 80
• Page End: 87
• Publication Date: 2020-01-02
• Subjects: fatal drug intoxication -- psychological autopsy -- suicide -- youth; Drug abuse -- Treatment -- Periodicals; Teenagers -- Drug use -- Periodicals; 616.860083
• DOI: 10.1080/1067828X.2020.1837322
• Languages: English
• ISSNs: 1067-828X

Abstract

Abstract: Background: Opioids and cocaine are the leading drugs for fatal drug intoxication (FDI). Manner of death may be accidental (i.e., unintentional); suicide (i.e., intentional), or undetermined. Difficulties of the medical examiner (ME) in confirming the manner of death by a standard investigation may result in underreporting of intentional FDI thus limiting efforts to identify, reduce, and prevent it. Objective: Examine the rate of youth intentional and undetermined FDI and address the need for closing the gap in the determination of intentional FDI among youths by the addition of a psychological autopsy. Method: Two hundred ninety-three (293) consecutive FDI case files from the State of Connecticut Office of the Chief Medical Examiner were reviewed. The case files were those of youths, 10 to 25 years of age, who died between January 1, 2016, and December 31, 2018. Results: The annual intentional FDI rates among this group were between 3% and 5%. Undetermined manner of death rates were between 0% and 5% percent, while the remaining cases was reported as accidental. A majority of the FDI cases involved youths 20 to 25.11 years old, while a small percentage were among those ages 15 to 19.11 and none for 10 to 14.11. Male-to-female ratio was approximately 2:1 in all categories of FDI. Conclusion: These low rates of intentional FDI among youths support the arguments regarding limitations in the procedures employed by a ME to determine intent. There is a need for an individual-level study of a multipronged approach to identify modifiable acute high-risk circumstances for intentional FDI, including a psychological autopsy.