A retrospective study of OCME cases in 1992 and 1993 yielded a total of 605 deaths caused by drugs of abuse: 426 narcotic drug use, 66 cocaine, 102 PCP, and five involving both PCP and narcotic drugs. Most victims were male and black, ranging in age from 15 to 68. Sixty-five percent had a known history of drug abuse. Twenty-nine cases showed complications of drug abuse, including pneumonia, endocarditis or myocarditis, pulmonary embolism, AIDS, and intracerebral hemorrhage. Eighty-seven (14.4 percent) were positive for HIV antibodies, an incidence much higher than that in the general autopsy population (2.6 percent). The authors of this study identified five reasons for the dramatic increase in drug deaths, especially heroin deaths: (1) nationwide increase in the purity of street-level heroin; (2) significant decrease in the market price of heroin; (3) wider and easier availability of heroin; (4) transition from cocaine addiction to heroin addiction; and (5) significant shift from intravenous injection to intranasal use, which is easier, carries less risk of infection, effective, and could lead some naive or infrequent users to heroin addiction. Tables, figures, references