The study included all deceased who died in relation to psychoactive substances abuse in the regions of Bratislava and Trnava city districts within a two-year period of the years 2007-2008. All the cases were autopsied by the standard method completed with toxicological analyses. There were reported total 84 fatalities related to psychoactive substances. From this amount, 38 cases (45 %) belong to the group of direct deaths (poisonings) and 46 cases (55 %) to the group with other cause of death. Out of the total number, 83 % were related to men and 17 % to women. More than 50 % of the cases were related to the age up to 34 years. In the group of poisonings, the most frequently detected substances were opioids themselves or in combination with other substances in 53 %. In the group of the indirect deaths, the most frequent category of death was suicide in 39 %. The most frequently detected psychoactive substances were central nervous system stimulants in 40 % of cases (Tab. 6, Fig. 1, Ref. 16).