Table 1.
Examples of scene findings suggesting opioid misuse or abuse
| Opioid medications |
| History of methadone use |
| Evidence of intravenous drug abuse (needles, cooker spoons, tourniquet, crushed tablets, packets of powder or crystals, other drug paraphernalia) |
| Overlapping prescriptions for the same type of prescribed controlled substances, prescriptions for controlled substances from multiple pharmacies or multiple prescribers |
| Prescriptions in other people’s names |
| Pills not stored in prescription vials or mixed in vials |
| Injection sites not due to resuscitation attempts |
| Altered transdermal patches |
| Many transdermal patches on body or transdermal patches in unusual locations, e.g., mouth, stomach, vagina, or rectum |
| Application of heat to increase the rate of transfer of drug from transdermal patch to decedent |
| Presence of naloxone |