A post-mortem examination is a reliable method to reveal possible hidden causes of death. However, due to the stigma associated with drug use, mortality data related to drug use is a neglected topic in local health in Palestine. Therefore, we aimed to describe post-mortem examination cases' mortality data and investigate the occurrence of death-related drug use in the West Bank in a retrospective study, 2011-2021. Homicide was more prevalent among males (32.9%) than females (20.9%), with increased risk in young adults (OR=2.8) and the summer season (OR=1.9). Moreover, Palestinian refugees were three times more likely to commit homicide than urban (OR=30.3). Most suicide cases were males and with increased risk in children (OR=4.9) and young adults (OR=8.7) than age group>40 years (p-value<0.05). In mortality data related to intoxication, organophosphates were the leading cause of death in suicidal cases and multidrug misuse in unintentional death. Amphetamines were the most drugs found in combination with other drugs. Most of the deaths related to drug use were male prominent and from villages. In conclusion, age-related increases in homicide and suicide rates highlighted the vital role of raising national health awareness and improving the health care system in rural areas and refugee camps. Moreover, the increased percentages of suicide and accidental death related to drug use, the age of victims, and the polydrug tested in these cases indicate a hidden population of multidrug users in young Palestinian adults and children, which designates drug use in Palestine has reached an alarming situation.

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