Tattoos and abuse of psychoactive substances in an autopsy population sample from Greece

In forensic context, tattoos are used mainly for identification purposes, but they can also provide evidence about the lifestyle of the decedent. This retrospective study examined autopsy cases that were conducted in the University of Athens Medical School in a 4-year period (2012-2015). Of a total 4274 autopsies carried out in this period 285 decedents (258 males and 27 females) appeared to have at least one tattoo. The majority of these deaths (61.4%) were determined to be due to non-natural causes. Specific tattoo designs appeared to be directly related to positive history for psychoactive substance abuse or positive toxicological analysis for psychoactive substance use, A high relation between Christian religious symbols and heroin use was notable. Moreover, psychoactive substance abuse was also found to be directly related to the visibility of tattoos as tattoos at the head, the neck and the hands appeared to be related to positive history of substance abuse or to positive postmortem toxicology findings. Further research is needed hi the field of tattoos and substance abuse not only in specific social groups, but also in the general population in order to be able to better interpret tattoos on deceased individuals.