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Methamphetamine is the most abused drug in Korea followed by cannabis and opiates. Recent characteristics of the drug problem in Korea include increased drug smuggling from abroad, drug trafficking by organized gangs, varieties of drug smuggling, foreigners engaged in drug smuggling, and spread among drug abusers and areas. New drugs such as MDMA, Yaba, and LSD are found in greater proportion in the seizure records, indicating diversification of smuggled drugs in Korea. In addition, there is a growing tendency for the abuse of common medicines among young people in Korea because they are easily available. Methamphetamine is so seriously abused that fatalities from its overdose have occurred; since 1985, 20 such fatalities have been reported. Many deaths from the abuse of noncontrolled substances, especially dextromethorphan, zipeprol, and carisoprodol, which are taken for their hallucinogenic effects, were also reported. Recently, there was even a fatality related to smuggling of cocaine by body-packing.

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A 22-year-old male with more than 28 needle marks on his right arm was found dead. First, he was suspected as a drug abuser. Blood, urine, spleen, and injection-site tissue was collected during autopsy. The blood and urine specimens were screened for drugs. Immunoassay studies did not show any illegal drugs. However, two unidentified peaks were isolated in both of these biological fluids by routine gas chromatography-flame-ionization detection (GC-FID) and thermionic specific detection. Additional gas chromatography-mass spectrometry analysis determined these two peaks to be tiletamine and zolazepam. These two agents are used in combination as veterinary anesthesia. The concentrations of these drugs in blood were quantitated by GC-FID and found to be 0.85 mg/L of tiletamine and 3.3 mg/L of zolazepam. In urine, tiletamine and its metabolite, 2-(ethylamino)-2-(2-thionyl) cyclohexanol, were identified to be present along with zolazepam. The concentrations of tiletamine and zolazepam in spleen were revealed to be 0.92 and 3.5 mg/kg, respectively. Injection-site tissue concentrations were determined to be 25.1 mg/kg tiletamine and 23.3 mg/kg for zolazepam. The cause of death in this case was determined to be due to the multiple drug intoxication of tiletamine and zolazepam.