Forensic Toxicology

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Forensic Toxicology?
An examination of all aspects of toxicity
that may have legal implications.
This definition allows us to distinguish this
field from other fields such as
pharmacology, or occupational toxicology
which deals with toxicity of chemicals in
the workplace.

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What is a lethal Dose?

It is impossible and unwise for a
pathologist to comment about lethal
doses.
Although there is many tables assigning
numeric value to lethal doses, the
variables in many cases are too great to
make these types of predictions.

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What is a lethal Dose? (2)

Knowledgeable persons including forensic
hobbyist, defense attorneys and so on
often bring to light the idea of LD 50
LD50 is the idea that is used by
pharmacologist and companies in a
statistical sense in animal experiments.
LD50 = Over a large number of tests, it
provides a toxic level at which half the
animals will be expected to die.
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Autopsy and Poisoning

Suspected poisoning can be the most
difficult because:
The pathologist will have to base his results
on findings that are almost always
inconclusive.
Debate about the actual cause of death is
almost insured at trial.

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Collection of Samples
Care must be taken in procedure because
speculation is inherent to the capabilities
of the pathologist.
The shorter the delay between death and
collection of samples the better.
Many toxins will be broken down naturally
by decay and cellular autolysis.

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Info give to toxicology labs

Personal data of deceased (age, sex, occupation).

Brief details of symptoms
Post mortem interval
Name and number of pathologist
List of all samples provided
Nature of preservatives used
Any delays in transporting of samples
Any special risks associated with samples being
handled.
In cases of homicide, a proper chain of custody must be
observed.
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Areas of Application (3)

Postmortem drug testing this is used in death
investigations to establish whether or not drugs
were the cause or contributing factor in death.
Workplace drug testing this consist of
evaluation of biofluids, primarily urine and blood
from employees or job applicants for drug
content.
Evaluation of Contraband this is applied when
evidence seized is being linked to the illicit drug
trade. Police agencies needed labs that could
link materials to illegal drug trafficking and
manufacture.
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Specimen Collection
Blood the most satisfactory method for
obtaining samples is from venous puncture of
the femoral vein.
An alternate site to collect venous blood is to
incise the jugular.
this is typically done after the neck has been
exposed under the sub-clavicular incision.
The correlation between blood concentration
and effects of the drug is very high in blood
testing.
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Specimen Collection
Urine in pre-employment screening urine is
most often used to test for presence of drugs.
This is typically because of the types of test that can
be run and the cost effectiveness of the testing.
One draw back to urine is the correlation between
drug concentration in urine and drug effects is usually
poor.
Urine should also be collected in post mortem
investigations since some toxins show in higher levels
in urine.
At autopsy, a catheter or suprapubic puncture will
suffice.
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Specimen Collection
Bile this can be useful in cases where
morphine and chlorpromazine are
suspected toxins.
These toxins are concentrated by the liver
and excreted into the gall bladder.
Direct collection of bile into a bottle is
advised because bile is too viscous to be
sucked through a needle.
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Specimen Collection
Cerebrospinal Fluid not often collected
for toxins, but may be needed for
microbiological analysis.
If needed it should be collected by lumbar
or cisternal puncture.
Cisternal puncture = Passage of a hollow
needle through the posterior anto-occipital
membrane into the cerebellomedullary cistern
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Specimen Collection
Vitreous Humor sometimes useful in
bodies with appreciable post mortem
decay.
The fluid in the eye resist putrefaction
longer than other body fluids.
Vitreous can also be used at estimating
time of death.
Puncture should be made through the
sclera with a 5 Gauge needle.
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Specimen Collection
Gastric Contents This is typically done in
a sudden death in which the deceadant
has large quantities of a lethal agent in his
stomach.
Contents should be emptied into a wide
mouth jar.
In the case of suicide, large amounts of toxins
in the gastric tract may make this point
apparent.
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Specimen Collection
Vitreous Humor The fluid found in the
center of the eye is the vitreous humor.
Since this is an isolated area in the body.
Vitreous humor is resistant to putrefaction.
This is especially handy in a case in which
there has been a great deal of decomposition
since vitreous humor may be the only fluid still
available to test.
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Specimen Collection
Bile and Liver the liver filters the blood
and is most heavily involved in drug
metabolism.
Because bile drains from the liver it is often
times very rich in certain types of drugs such
as opiates.

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Specimen Collection
Hair Not common in forensics for a
number of reasons.
Drugs only present in extremely low
concentrations.
Controversy between active and passive drug
usage arise.
The benefit of hair is that its is a good timeline
for drug usage since it is only eliminated when
hair is cut.
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Drugs of Abuse
Workplace drug testing is primarily
concerned with eliminating applicants with
drug problems and also explaining
dangerous or erratic behavior of current
employees.
It is important to recall that abusable
substances often have legitimate
medicinal applications.
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NIDA
National Institute on Drug Abuse initiated a
program to curb drug use by requiring all
federal employees be screened prior to
employment.
This program specified that screening
could cover only the drugs listed below
Ampetamines, opiates, phencyclidine,
cocaine, cannabinoids.
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NIDA testing for Amphetamine

Opiates and amphetamines are
considered to have high abuse potentials
and are focused on more in these testing.
Both amphetamine and methamphetamine
are covered in this testing.
Opiates included morphine and codeine.
Many labs provide testing for
benzodiazepines, barbiturates, and
hallucinogens.
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NIDA testing for Opiates

Opiates constitute a large class of drugs
distinguished by their ability to cause feelings of
euphoria.
Morphine, Heroin, Codeine all fall under the
umbrella as opiates as do common pain
relievers such as loratab, percacet, and many
other commonly prescribed pain medicines.
Semi-synthetic opiates are those made from
modification of morphine or codeine molecules.
These include hydromorphiene, OxyContin, and
Oxycodone.
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Amphetamines
In contrast to opiates, these drugs created an
excitatory condition characterized by elevated
heart rate.
They also illicit extreme feelings of euphoria.
These drugs have some of the highest
incidences of abuse.
Ecstasy (MDMA), LSD (lysergic Acid) Crystal
Meth ( methamphetamine) all fall under this
umbrella.
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Cocaine
Cocaine is a stimulant that resembles amphetamine in
its abusive potential.
Unlike amphetamine, cocaine is a natural stimulant
found in the coca leaf.
Cocaine can also be refined further to produce crack
cocaine which intensifies its euphoric effects and cost
effectiveness.
The reason for the increase of potency is because when
the drug is smoked, the large surface area of the lungs
allots rapid absorption into the body increasing the
euphoric feelings.
Cocaine is metabolized in the blood to benzoyleganine,
and that is what is tested for in labs.
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Cannabinoids
Marijuana is a name that applies to parts of the
Cannabis sativa plant.
Tetrahydrocannabinol (THC) is the major active
agent in marijuana.
Typically marijuana has a 2-6 percent by volume
concentration of THC, Hashish has much higher
concentration of THC roughly 12 percent.
The average marijuana cigarette contains about
75 mg of THC but it is rapidly absorbed into the
blood stream reaching peak concentration
around 10 20 minutes after smoking.
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Phencyclidine
Commonly known as PCP
Developed by the Park Davis company
and was intended for use as a surgical
anesthetic.
However it was found to be unsatisfactory because
some patients exhibited manic behavior after usage.
PCP is measured in blood or urine levels around 25
nanograms per milliliter. Levels of greater than 100
nanograms per milliliter have been related to seizure
and some deaths.
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Alcohols
Ethanol is beverage alcohol.
Low molecular weight alcohols such as
methanol and isopropyl may also contribute to
human injury.
It takes around 90 minutes for the peak level of
ethanol to enter the blood.
Gas Chromatography is the preferred method for
testing alcohol in blood and a proper chain of
custody must be observed for criminal cases.
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Cyanide
Highly toxic substance found in various places
throughout nature.
Cyanide is dangerous because it binds with ferric ions in
cytochrom oxidase, which is an enzyme critical for
electron transport.
Because it interrupts electron transport it stops the
bodies main mechanism for energy production.
Most labs can test for cyanide in whole blood and its
concentration correlates well with severity of poisoning.
Levels higher than 1000 nanograms per mil are
associated with stupor and amounts greater than 2500
nanograms per mil are usually fatal.
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Carbon Monoxide
Some studies suggest that CO causes
more deaths than any other toxin.
This is because CO is present in all fires
and typically is the cause of death in fire.
CO binds to hemoglobin much more tightly
than O2 does and decreases our bloods
ability to carry oxygen.
CO also binds with myoglobin which is
also important in electron transport.
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Analytical Methods in Forensic

Toxicology
The methods used in testing of biofluids is
important as the types of fluids that are
tested.
A good working relationship between death
investigators and laboratories is essential in
success of solving death investigations.
Remember, death investigation is a team
effort and toxicology is a vital member of the
team.
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Screening Tests

Immunoassays
Fluorescence chemiluminescence
Thin Layer Chromatography
Ultra-Visible Spectrophotometry
Gas Chromatography
Gas Chromatography-Mass Spectrometry
Chemical Ionization
Liquid Chromatography-Mass Spectrometry
Colorimetric Assays
Atomic Absorption Specrophotometry (AAS)
Neutron Activation Analysis (NAA)
Inductively Coupled Mass Spectrometry (ICP-MS)
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Interpreting Findings
Workplace drug testing is usually
conducted for the purpose of answering
one of two questions
History of drug use for hiring purposes or
explanation of erratic behavior of current
employee.
Table 5.4 page 75 shows cutoff levels for
positive specimen levels.
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Interpreting Findings
The goal of a forensic toxicologist is to
confer with the pathologist in determining
the cause and manner of death.
In simple terms we infer that the death is
due to a specific toxin when appropriate
quantities of that toxin are found.
When other findings conclude cause of
death we may specify the toxin as a
contributing factor to death.
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