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In Memphis and the surrounding county, there were a record number of homicides (179) in 1986. During the same year, there was a marked increase in medical examiner cases where tests were positive for cocaine or its metabolites. Review of medical examiner and toxicology records from 1980 to 1986 found 87 cocaine related deaths; 46 of these were homicides. In 1986 alone, there were 53 cocaine related deaths, all manners, and 31 cocaine related homicides. In this year, 17.3% of the homicides were positive for cocaine or metabolite. The cocaine related homicides were similar to other homicides in terms of age, race, sex, blood ethanol concentration, and cause of death being due most often to firearms. In homicide cases in which an abuse drug was detected, cocaine accounted for the entire increase in 1986. Police records indicated that cocaine directly contributed to the homicide in 39% of the cases in which the drug was found. In other cases, we speculate that cocaine altered behavior may have contributed to the victim's being murdered either during the drug “high” or during the posteuphoric depression or withdrawal phase.

Cranial exit wounds typically display external beveling, however, variation has been noted in the literature due to keyhole phenomena and pre-existent fractures. Two cases of atypical exit morphology are presented with features mimicking blunt trauma. In both instances radial fractures created by the exiting impact allowed passage without producing exit beveling. A working knowledge of the biomechanics of bone fracture, radiographs and low power microscopy are essential elements for the proper interpretation of such exit wound fractures.