Drug combo mimicking cocaine in autopsy

Is there be a combination of legal drugs that would be taken to treat a legitimate illness that would show up as cocaine in an autopsy?

I don’t know how this would work in an autopsy, but if you’re going for urine and blood tests, those and the like often look for metabolites, not the actual substance. Cocaine becomes primarily Benzoylecgonine, along with several others. The article mentions a drug Esterom (pain killer), but I have no idea whether an experienced examiner would be able to distinguish the two. It would seem that the lack of the other metabolites is a sign that it’s not cocaine, but some tests may only look for one or a few metabolites.

Forensic toxicology uses gas chromatography/mass spectrometry (GC/MS) which separates substances by mass and by electrical charge. The people who run these run the unknown sample against standards containing known quantities of drug metabolites. There is pretty much no way of inadvertently fooling one of these systems, so no.

Are you thinking of something like the “cocaine mummies,” or a medical examiner investigating a recent death?

I’m thinking medical examiner. Fellow dies in car crash. ME finds cocaine in his system. Family claims it was combo of medications. Any chance the family is right?

No. See my above post.

The only way this would work is if one of the prescription drugs metabolized to one of the same things that cocaine is metabolized to. IANA pharmacist, but I don’t think there are any prescription drugs for which this is true.

So the ME would put a blood sample in a GC/MS machine and it would separate the different substances and chemicals in the blood? Cool beans