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Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022
Background: Unnatural deaths, which include homicides, suicides, and accidental deaths, often require toxicological analysis to assist with determining the cause of death. In 2022, the Forensic Toxicology Unit within the Western Cape Forensic Pathology Service piloted a targeted drugs analysis at Sa...
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| Format: | Thesis |
| Language: | English English |
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Department of Pathology
2025
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| _version_ | 1867613215435784192 |
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| access_status_str | Open Access |
| author | Munarini, Murendwa Success |
| author2 | Davies, Bronwen |
| author_browse | Davies, Bronwen Munarini, Murendwa Success |
| author_facet | Davies, Bronwen Munarini, Murendwa Success |
| author_sort | Munarini, Murendwa Success |
| collection | Thesis |
| description | Background: Unnatural deaths, which include homicides, suicides, and accidental deaths, often require toxicological analysis to assist with determining the cause of death. In 2022, the Forensic Toxicology Unit within the Western Cape Forensic Pathology Service piloted a targeted drugs analysis at Salt River Mortuary in Cape Town. This permitted an assessment of commonly misused drugs in suspected unnatural and/or unexplained deaths, which was previously not feasible, given the backlogs of National toxicological analyses. Aim: To assess toxicological findings of a targeted LC-MS/MS drugs of misuse panel in suspected unnatural death cases in the west metropole of Cape Town, Western Cape. Methods: A retrospective, descriptive study was conducted on all cases for which specimens were submitted to the Forensic Toxicology Unit between 1 January 2022 and 31 December 2022 for a targeted drugs analysis of 31 analytes using LC-MS/MS. Blood alcohol and toxicology results from the National Forensic Chemistry Laboratory were also compared within the cohort. Results: The Forensic Toxicology Unit analysis was requested in 735 cases, with qualitative (n=723, 98.4%) and quantitative (n=108, 14.7%) analyses performed. Drugs were detected in 382 (52.8%) of the 723 cases analysed. The most frequently detected drugs were acetaminophen (24.8%), methamphetamine (17.6%), amphetamine (14.4%), methaqualone (13.8%) and THC-COOH (12.9%). Blood alcohol analysis was requested from the National Forensic Chemistry Laboratory in 541 cases (73.6%), and ethanol was detected (≥0.01 g/100mL) in 138 (25.6%) of these cases, with a mean positive BAC of 0.14 ± 0.02 g/100 mL (range: 0.01-0.54 g/100 mL). Conclusion: This study revealed that commonly misused drugs were frequently present in suspected unnatural and/or unexplained deaths admitted to Salt River Mortuary in Cape Town. However, given that only a portion of cases were submitted for analysis, and that the panel was limited in scope, it does not represent the full landscape of drug exposure in unnatural deaths. Nonetheless, this study represents the first comprehensive data on drugs (other than alcohol) in post-mortem toxicology casework in South Africa, using validated methodology. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/41813 |
| institution | University of Cape Town (South Africa) |
| language | English eng |
| last_indexed | 2026-06-10T12:32:36.207Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Department of Pathology |
| publisherStr | Department of Pathology |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/41813 Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022 Munarini, Murendwa Success Davies, Bronwen du Toit, Chanté Unnatural deaths homicides suicides accidental deaths Forensic Toxicology the Western Cape Forensic Pathology Service Background: Unnatural deaths, which include homicides, suicides, and accidental deaths, often require toxicological analysis to assist with determining the cause of death. In 2022, the Forensic Toxicology Unit within the Western Cape Forensic Pathology Service piloted a targeted drugs analysis at Salt River Mortuary in Cape Town. This permitted an assessment of commonly misused drugs in suspected unnatural and/or unexplained deaths, which was previously not feasible, given the backlogs of National toxicological analyses. Aim: To assess toxicological findings of a targeted LC-MS/MS drugs of misuse panel in suspected unnatural death cases in the west metropole of Cape Town, Western Cape. Methods: A retrospective, descriptive study was conducted on all cases for which specimens were submitted to the Forensic Toxicology Unit between 1 January 2022 and 31 December 2022 for a targeted drugs analysis of 31 analytes using LC-MS/MS. Blood alcohol and toxicology results from the National Forensic Chemistry Laboratory were also compared within the cohort. Results: The Forensic Toxicology Unit analysis was requested in 735 cases, with qualitative (n=723, 98.4%) and quantitative (n=108, 14.7%) analyses performed. Drugs were detected in 382 (52.8%) of the 723 cases analysed. The most frequently detected drugs were acetaminophen (24.8%), methamphetamine (17.6%), amphetamine (14.4%), methaqualone (13.8%) and THC-COOH (12.9%). Blood alcohol analysis was requested from the National Forensic Chemistry Laboratory in 541 cases (73.6%), and ethanol was detected (≥0.01 g/100mL) in 138 (25.6%) of these cases, with a mean positive BAC of 0.14 ± 0.02 g/100 mL (range: 0.01-0.54 g/100 mL). Conclusion: This study revealed that commonly misused drugs were frequently present in suspected unnatural and/or unexplained deaths admitted to Salt River Mortuary in Cape Town. However, given that only a portion of cases were submitted for analysis, and that the panel was limited in scope, it does not represent the full landscape of drug exposure in unnatural deaths. Nonetheless, this study represents the first comprehensive data on drugs (other than alcohol) in post-mortem toxicology casework in South Africa, using validated methodology. 2025-09-15T13:17:52Z 2025-09-15T13:17:52Z 2025 2025-09-15T13:15:59Z Thesis / Dissertation Masters MPhil http://hdl.handle.net/11427/41813 en eng application/pdf Department of Pathology Faculty of Health Sciences Universiy of Cape Town |
| spellingShingle | Unnatural deaths homicides suicides accidental deaths Forensic Toxicology the Western Cape Forensic Pathology Service Munarini, Murendwa Success Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022 |
| thesis_degree_str | Master's |
| title | Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022 |
| title_full | Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022 |
| title_fullStr | Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022 |
| title_full_unstemmed | Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022 |
| title_short | Investigating the role of commonly misused drugs in suspected unnatural and/or unexplained deaths in Cape Town in 2022 |
| title_sort | investigating the role of commonly misused drugs in suspected unnatural and or unexplained deaths in cape town in 2022 |
| topic | Unnatural deaths homicides suicides accidental deaths Forensic Toxicology the Western Cape Forensic Pathology Service |
| url | http://hdl.handle.net/11427/41813 |
| work_keys_str_mv | AT munarinimurendwasuccess investigatingtheroleofcommonlymisuseddrugsinsuspectedunnaturalandorunexplaineddeathsincapetownin2022 |