Death and forensic toxicology in Swedish poisonings

Background: Approximately 1% of Sweden's 90,000 annual deaths are caused by poisoning. In this study we aim to describe this poisoning population's characteristics, autopsy frequency, and results of toxicology testing. Method: A national cohort study based on Swedish national registers. All deceased patients older than 18 years with poisoning as the cause of death registered between 1 th January 2000 to 31 th December 2021 were included. Causes of death according to primary ICD-10-code were analysed along with the substances found in forensic chemistry testing. Results: There were 27,057 poisonous deaths during the study periods 2,018,495 total adult deaths. Patients deceased due to poisoning had a median age of 53 years and 18,838 (70%) were men. A private home was the most reported location of death (52%). In total did 23,260 (87%) undergo some sort post-mortem examination. Drugs (synthetic narcotics, opioids, heroin) caused 12,448 (46%) deaths and alcohols explained 9,056 cases (33%). Positive toxicological tests were found in 22,550 (83%) of the subjects. The most common separate substances were ethanol, zopiclone and, nordazepam. Conclusion: Poisoning causes 1.3% of Swedish deaths. Men in their fifties are the most common victims and their death are often cause by synthetic narcotics, other opioids, or alcohol. The autopsy frequency is lower than expected for poisonous deaths.