Postmortem findings of organ damage in novel psychoactive substances users: A comprehensive review

Neurosci Biobehav Rev. 2024 Dec:167:105927. doi: 10.1016/j.neubiorev.2024.105927. Epub 2024 Oct 22.

Abstract

Introduction: Despite the rising number of NPS-related deaths, comprehensive data on their prevalence, identification, and associated organ damage remain scarce.

Materials and methods: A literature search was conducted. Predefined inclusion and exclusion criteria were applied, resulting in the identification of 197 articles.

Results: We identified 446 cases of NPS-related deaths, involving a total of 176 different substances. Synthetic opioids were the most prevalent class (34 %), followed by synthetic cannabinoids (22 %) and cathinones (21 %). Co-ingestion of NPS with other substances occurred in 77 % of cases. Macroscopic findings varied across organs, with congestion and edema most observed in the brain (23 %) and lung (56 %), respectively.

Discussion: The existing literature lacks comprehensive descriptions of organs subjected to autopsy and histological examination in NPS-positive subjects. Despite this limitation, our findings underscore the prominence of lung pathology. Moreover, the prevalence of normal organs in cases of acute intoxication is a significant observation. We advocate for future research to provide more detailed insights to enhance our understanding of the multifaceted landscape of NPS-related deaths.

Keywords: Autopsy; Cathinones; Novel psychoactive substances (NPS); Polydrug use; Substance abuse; Synthetic cannabinoids; Synthetic opioids.

Publication types

  • Review

MeSH terms

  • Autopsy*
  • Brain / drug effects
  • Brain / pathology
  • Humans
  • Illicit Drugs / adverse effects
  • Lung / drug effects
  • Lung / pathology
  • Psychotropic Drugs* / adverse effects
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / pathology

Substances

  • Psychotropic Drugs
  • Illicit Drugs