A newly published scientific review suggests that genetic differences affecting how people metabolize drugs could provide valuable additional information in forensic death investigations, particularly when toxicology results do not fully explain the circumstances of death.
Published on November 14, 2026, in the Journal of Analytical Toxicology, the review examines how pharmacogenomics, a field that studies the relationship between genetic variation and drug responses, could be applied to postmortem toxicology.
The research was authored by Kezia Jobi, Sharlize Pedroza Matute and Sasitaran Iyavoo, researchers affiliated with the University of Greenwich, the University of Lincoln and AttoGroup Limited in the United Kingdom.
Forensic toxicologists routinely examine blood and tissue samples to identify drugs and estimate their concentrations. However, interpreting these findings is not always straightforward.
Two individuals exposed to similar drug doses may experience different effects because of variations in metabolism, tolerance, health conditions and interactions with other substances.
Pharmacogenomics offers a potential way to investigate some of these differences.
The review focuses particularly on genetic variations affecting cytochrome P450 enzymes, a group of enzymes involved in metabolizing many medications and other compounds.
Inherited differences in the genes encoding these enzymes can influence how quickly certain drugs are processed.
For example, reduced activity of a relevant metabolic enzyme may contribute to higher concentrations of a parent drug or alter the balance between a drug and its metabolites.
Such information could be useful when investigators encounter toxicology results that appear inconsistent with a person's reported medication history or the circumstances surrounding a death.
However, the authors emphasize that genetic variation alone cannot reliably establish how a drug was metabolized before death.
Other medications, disease and environmental factors can change enzyme activity, sometimes producing a functional metabolic state that differs from what a person's genotype would predict.
This phenomenon is known as phenoconversion.
The review also discusses the importance of considering interactions between drugs and genes, rather than interpreting individual genetic markers in isolation.
Postmortem redistribution presents another challenge. Drug concentrations may change after death as substances move between tissues and blood, complicating comparisons with concentrations measured in living patients.
The authors identify several obstacles to implementing pharmacogenomic testing in routine forensic investigations, including specimen quality, analytical requirements, interpretation standards and the absence of widely established forensic-specific guidelines.
They suggest that improved specimen preservation practices and emerging molecular methods could help support future applications.
Importantly, the publication is a review of existing scientific knowledge, not a new experimental validation study.
It does not establish that pharmacogenomic testing can independently determine whether a drug caused a person's death.
Instead, the authors recommend interpreting genetic findings alongside conventional toxicology, autopsy findings, medical and prescription records, and evidence from the death scene.
The review highlights a developing area of forensic science in which genetic information may eventually help investigators interpret complex toxicological findings more precisely, while reinforcing the need for cautious, evidence-based conclusions.