Iliac crest bone biopsies were obtained at autopsy from 28 subjects (21 male, 7 female, aged 18 to 45 years) who had a history of drug abuse and had died of an overdose of illicit drugs. For histomorphometry, undecalcified sections were investigated using the Merz grid. In 28 controls (24 male, 4 female, aged 17 to 47 years) trabecular bone specimens were investigated in the same way. The parameters in drug addicts did not show any correlation to age, body weight, height or sex differences. Trabecular bone volume and trabecular thickness were slightly but not significantly increased. Only the eroded surface was significantly different in the controls. The article concludes that, although drug abuse may interfere with bone metabolism, the possibility of osteopenic metabolic bone disease and the syndrome of diffuse osteosclerosis in drug addicts seems to be low. However, not only bone biopsies of the iliac crest and lumbar vertebrae but also X-ray investigation of at least the axial skeleton and the long bones are necessary at autopsy in cases of death associated with drug abuse. Tables, figures, references