Background: About 24 to 40 percent of hospital admissions are due to addiction and its complications. Determination of a marker for substance abuse, especially in cadavers is very useful for diagnosis and the cause of death.

Method: This study was conducted to evaluate association between substance abuse and Hemosiderin-Laden in alveolar macrophages in all cadavers referred to Tehran Legal Medicine Center in 2009. In this study, 40 cases, referred to our medico legal center were evaluated for possible addiction to opium, Heroin or Crack, documented by Cocaine strip test or gas chromatography test. The lung autopsies were taken from both addicted and non-addicted and after staining, they were evaluated for the number of Hemosiderin-Laden macrophages had any significant difference between two groups.

Findings: A total number of 40 fatal cases were studied (35 men and 5 women mean age range was 30 years). The cases had a minimum exposure range of 1 to 20 years lifetime, of which 28% had used drugs approximately 10 years. The methods for using drugs were as followed: injection (50%), oral (18.8%), inhalation (12.5%), injection and oral (12.5%), and inhalation and oral (6.2%). The most popular methods used by subjects were Heroin (25%). The number of Hemosiderin-Laden macrophages detected in lung autopsies significantly increased in addicted ones. Results showed that the difference between case and control groups is significant statistically.

Conclusion: Consequently, this study confirmed previous study findings and showed that Hemosiderin-Laden in alveolar macrophages is a useful marker for diagnosing chronic drug abusers.