Not all jurisdictions do toxicological testing if the case is a suicide (37,110). Ethanol is found frequently; it is detected in one-fourth to one-half of self-inflicted injuries in various studies (19,30,32,34,35,37,49). Ethanol (>20 mg/dL) was found in

Fig. 53. Microscopic slide from edge of contact entry wound. Carbon material on intact epidermis (large arrow) and denuded dermis (small arrow). Dermal collagen altered (arrowheads; H&E, original magnification x25).

65% (13 of 20) of perpetrators of murder-suicide in a Texas series (24). Other drugs are detected in one-fourth of suicides (37). In special circumstances, other agents have been detected (e.g., detection of cyanide, a breakdown product of tear gas, in blood [73,93]). Despite a history of depression in many elderly perpetrators of murder-suicide, few have detectable levels of antidepressants (52).

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