Postmortem Analysis and Interpretation of Alcohol

Alcohol (ethanol) is the most common drug detected at postmortem examinations when deaths are brought to the attention of coroners, medical examiners, and police. The measurement of alcohol can proceed in the same way as for alcohol determinations in living persons; however, a wider range of specimens should be taken. Peripheral blood (preferably two specimens), urine, and vitreous humor are recommended in all death investigations, particularly, when alcohol testing is required. A comparison of alcohol concentrations in blood with one or more of the other specimens helps to determine if the blood–alcohol concentration properly represents the concentration at death. A number of postmortem processes operate, which can affect the concentration of alcohol. These include processes that increase the concentration because of bacterial action, diffusion from the gastrointestinal tract, or contamination from embalming fluid to processes that decrease the concentration because of chemical oxidation, bacterial attack, or evaporation. Consequently, the interpretation of alcohol content in deceased persons requires significantly more consideration than in most other situations.