Akademik Veri Yönetim Sistemi
Legal Medicine, cilt.82, 2026 (SCI-Expanded, Scopus)
Gabapentinoids are increasingly encountered in medico-legal death investigations, yet their role in fatal outcomes remains difficult to interpret when evaluated in isolation from contextual and toxicological complexity. This autopsy-based retrospective study examined deaths attributed to pregabalin and/or gabapentin intoxication within a national forensic board system, focusing specifically on cases interpreted in the context of non-medical use and polydrug involvement. Cases were identified through systematic review of board-level expert opinion files, and demographic characteristics, clinical background, event circumstances, postmortem toxicology findings, and cause-of-death determinations were evaluated. Toxicological results were interpreted alongside autopsy findings and scene information, and deaths were thematically classified according to patterns of substance involvement. Quantitative blood concentrations were assessed where available. Sixty-eight cases were included. Decedents were predominantly young to middle-aged males, with a high prevalence of documented substance use disorder. Combined substance exposure was the dominant pattern, most commonly involving illicit drugs, alcohol, or additional psychoactive medications. Isolated gabapentinoid intoxication accounted for a minority of cases. Fatalities most frequently occurred in private residences and were commonly discovered by family members or acquaintances, reflecting concealed patterns of combined substance use. These findings underscore that gabapentinoid-related deaths are seldom attributable to isolated toxicity and are best interpreted within the broader context of non-medical use and polydrug exposure. Autopsy-based, integrated forensic evaluation provides critical insight into these deaths and remains essential for accurate and defensible cause-of-death determination in cases involving gabapentinoids.