What role do medications play in a Death Investigation?


When we go to a scene, one of the things we look for are medications. The reason for this is that we can obtain a lot of information from them. The types of medications can tell us what conditions the decedent has. We check to see if they have been taking them as directed, or not enough, or too many and too often. Are all of the medications being taken by the decedent actually prescribed for the them? Are the medications current, or are they taking an old or expired medication?  Is there a regular physician prescribing the medications, or are there multiple prescribers and/or multiple pharmacies being used? Where are the medications kept? Is there a bottle open or very near the decedent, possibly indicating they were taking, or attempting to take medication, just before their death? Are there medications which could have a serious interaction when taken at the same time? What medication conditions do the medications indicate? Temporary, serious, terminal? How about psychotropic medications? Was the decedent suicidal or delusional in which they might accidently, or purposely, overdose with the intent of death?

As you can see there is so much information we can and need to obtain regarding medications.  They can also direct us to which pharmacy and physician(s) to contact.  By contacting the pharmacy to confirm the medications as well as find out if there are prescribed medications not represented at the scene or known by the family. It is amazing and frustrating at the same time as to how many spouses/family members have no idea about the health and conditions of someone.  On the other hand, people (like me) who have worked in a medical or related field (such as a detective) will often make lists of their medications, medical history, and the people to contact in case of emergency or death.  Below I have listed just a few of the medications usually found at death scenes, or the decedent’s residence. These are just a few examples of common medications we find at scenes.

Metformin, Glyburide, Insulin – diabetes

Alprazolam, Ativan, Valium, Lorazepam, Trazodone, Seroquel – anxiety and /or depression

Atenolol, Propranolol, Cardizem, Enalapril, Nitroglycerin – cardiac disease, hypertension

Hydrocodone, Darvocet, Fentanyl, Oxycontin, Soma – pain (chronic or acute)

Carbamazepine, Clonazepam, Phenobarbital, Dilantin – seizures

Warfarin, Coumadin, Aspirin – blood thinners

Sumatriptan, Imitrex – Migraines

Compazine – nausea

Retrovir – antiviral commonly used for HIV

The individual medications would be counted, and listed in my field notes.  If their amounts are off, either too much or too little, we can instruct the lab to make sure the medication in question is included in the panel run. If any illegal medications or drugs are discovered, we can make sure those are included in the panel as well.  One of the resources I used very often, was Pill Identifier (Pill Finder) – Drugs.com the Drugs .com pill identifier.  This site is free and the drug identifier option allows you to identify prescription, as well as many over the counter, medications by their stamped markings on them (the numbers and letters on each pill).

On a side note – if you have someone, or ARE someone, who has multiple prescription medications and medical conditions, I strongly suggest making a list of them. Please add the regular physician, and any other pertinent information. If the person lives alone, I recommend keeping the list on the fridge or with the medications so it can be found easily by paramedics in case of emergency.  It is also handy to keep a copy for completing medical forms requesting medications.  I usually take a copy of my list with me to provide for my medical file when I go to my doctor, or to have a procedure, especially a surgery or medical procedure! Another recommendation I have is to use only one pharmacy.  By doing this, any medication conflicts will be more likely to be caught before damage is done.