Chapter 7: POISONING easily masked when mixed in water or food), if it causes symptoms that are delayed

and nonspecific or appear to be due to natural illness, and if it is readily obtainable and
FORENSIC TOXICOLOGY easy to work with (Stripp, 2007).

TOXICOLOGY ARSENIC
Toxicology is defined as the science that deals with knowledge of source, Arsenic is a metal that is not in itself poisonous; the arsenic compounds used
character and properties of poisons, their symptoms in the body, their pharmacological in insecticides, pesticides, herbicides, alloys, wood preservatives, additives to animal
actions, and their treatment. It is a study of the adverse effects of chemicals, such as feed, semiconductors and light emitting diodes, homeopathic medicines, paints, and
alcohol, drugs, poisonous gases, and industrial chemicals on living organisms. It is also ceramics are the ones that make potent poisons. Arsenicals have been used since
concerned with the detection and measurement of such chemicals through the analysis ancient times as the 'Poison of Kings' and the 'King of Poisons'. Although less common
of samples such as blood, urine or hair. today, arsenic is still being used, and sufficient doses can result in death.
Forensic toxicology involves the use of toxicology for the purposes of the law, Arsenic has been widely used for homicidal purpose as it is cheap, easily
especially when criminal activity is suspected. It encompasses the determination of role available, tasteless and odorless, and therefore cannot be detected in food or water.
of drugs and chemicals in accidental deaths and and suicides. Low doses can be given slowly over a long period of time so that death may appear to
be natural. Intentional poisonings most often involve rodent poisons or pesticides.
Examples of toxicology-related deaths Accidental occupational exposure to arsenic compounds occurs in industrial settings,
 a restless infant who was drugged in an attempt to promote sleep such as in the manufacture of pesticides or herbicides, and in smelting industries.
 a drugged student who became a homicide victim

 an intoxicated driverinvolved in a fatal car accident CYANIDES

 a middle-aged chronic pain victim who abused opioids and anxiolytics Cyanides are chemical compounds, many of which are highly toxic, Cyanide
 and an elderly individual with multiple debilitating medical conditions who products are used in several industrial processes, mainly for the mining of gold and
intentionallyor accidentally overdosed on medications silver, It is also employed in several chemical processes, such an fumigation, case
hardening of iron and steel, electroplating and photographic processing: Cyanide is a
NOTE!!! rapid-acting and deadly poison that can kill in a matter of minutes. Its use has been
All substances are poisons; there is none which is not a poison. The right dose relatively common in suicides and accidents, and has also been used in homiciden.
differentiates a poison from a remedy." In addition, people differ widely in their The most hazardous compound is hydrogen cyanide (also known as prussic
responses to many substances. Nonetheless, the forensic toxicologist is responsible for acid or hydrocyanic acid or HCN), very pale, blue, transparent liquid or colorless gas
detecting chemical agents in biological samples, and providing answers to the following that can kill a human within minutes. It has been used for capital punishment in gas
questions in order to assist the medico-legal investigation (Stripp, 2007, pp. 16-17). chambers and by terrorists as a chemical weapon.
Other common poisonous cyanide compounds include potassium cyanide
 What drug was taken, when, and how? (KCN) and sodium cyanide (NaCN), which come in the form of white crystalline salts
 Was the drug or drugs sufficient to kill or to affect behavior? with a faint almond like odor.
 Was a substance taken for therapeutic purposes, was it abused recreationally, Cyanide in salt form is often administered orally, but can also be an inhalation
was it used for suicidal purposes, or was it administered homicidally? hazard when dissolved in acidic liquids. The toxicity of cyanide is due to its ability to
 Was the person intoxicated at the time of the incident? stop cellular respiration and ATP. synthesis in cells, thereby causing anoxia.
 What are the effects on behavior or performance? • How would a person show Symptoms of poisoning include headache, dizziness, nausca, vomiting,
intoxication with this substance? shortness of breath, and mental deterioration. Ultimately, seizures, apnea, coma, and
 Is there an alternative explanation for the findings? cardiac arrest cause death.
 What additional tests might shed light on these questions?
STRYCHNINE
A poison is a substance or agent capable of producing harm, such as disease Strychnine is a highly toxic crystalline alkaloid usually obtained from the seeds
or death, to a living organism. It may be introduced through any route in the body, such ofmthe Strychnosnux-vomica tree, which is commonly found in India and Southeast
as the mouth, nostril, anus, vagina, ears, eyes, or by injection or inhalation. Legally, a Asia. It is odorless and appears as a white or translucent crystal or crystalline powder,
poison is a substance which, if applied or administered internally, is said to be used with an extremely bitter taste that can easily be detected in foods and beverages. It is
with the intention to kill or to afflict harm. primarily used as a pesticide against rodents. Fatal poisoning can occur following
Poison can be an efficient and deadly instrument of murder if it is toxic enough exposure by inhalation, swallowing or absorption through eyes or mouth. It produces
even at small quantities, if it can be easily disguised (e.g., the taste or odor can be excruciatingly painful and violent spastic reactions, resulting in a horrific death. A lethal
dose results in painful muscle cramps, followed by extremely intense muscle Characteristic symptoms of thallium poisoning include loss of hair, paresthesia
contractions that are worsened by the slightest external stimulus such as a simple (damage to peripheral nerves causing pain in the hands and feet described as a
touch. The convulsions appear to resemble seizures, but the victim is completely sensation of walking on hot coals), endocrine disorders, gastrointestinal and pulmonary
conscious and aware of the painful event. At this point, the contractions will progress, distress, psychosis, delirium, and convulsions. Death may result from cardio-respiratory
ultimately resulting in death due to asphyxiation caused by muscle spasms. The collapse (Stripp, 2007 and Saukko & Knight, 2004).
deceased person is usually seen with an intense, blank, and frightening stare (Stripp,
2007). ACONITE
Aconite (or aconitine) is a toxin produced by the Aconitum napellus plant,
CARBON MONOXIDE which is also known as monk's hood, wolfs bane, women's bane, devil's helmet and
Carbon Monoxide is a highly toxic gas produced by the incomplete combustion blue rocket; it is found chiefly in mountainous parts of the northern hemisphere. Once
of organic materials. It forms when there is insufficient oxygen to produce carbon believed as the most toxic substance known to man, it has been historically used to
dioxide. It is colorless, odorless, tasteless and initially non-irritating; hence, it is very poison arrow and lance tips, to kill condemned criminals, and to poison the water
difficult for people to detect. supply of enemies. Women were thought to be especially vulnerable to the poison.
Carbon monoxide produces its toxic effects by binding to hemoglobin in red Aconite is a white powder that is barely soluble in water but very soluble in alcohol. The
blood cells and thus preventing oxygen from binding, which in turn causes tissue anoxia rapidly acting poison takes effect within minutes of exposure and targets the electrically
and impairment of ATP synthesis. Early symptoms of poisoning include progressively excitable cells of the nervous, cardiovascular and skeletal muscular tissues, causing
worsening headaches, light-headedness, nausea, light-headedness, fatigue, visual abnormal and potentially fatal heart rhythms. Early symptoms include a tingling and
disturbances, mental confusion, and eventually coma and death. Prolonged exposure numbness at the point of contact (usually the mouth and throat), sweating and nausea.
can lead to brain damage and death. The most significant post-mortem change in This sensation then spreads to the extremities, accompanied by visual and auditory
carbon monoxide poisoning is a cherry red color of the blood, which manifests itself as disturbances, severe vomiting, colicky diarrhea, intense pain and convulsions, and then
a reddish coloration of the skin (Stripp, 2007). paralysis of the skeletal muscles leading to death from respiratory failure (Stripp, 2007;
Sharma, 2011)
Saukko and Knight (2004) identify the following common causes, among
others, of carbon monoxide poisoning: RICIN
 Faulty heating systems that lead to absent or inadequate ventilation Ricin is a highly toxic, naturally occurring protein derived from the seeds of the
 Automobile exhaust fumes confined to a small space, producing a lethal castor oil plant Ricinus communis. Ricin is twice as deadly as cobra venom and it is
concentration of carbon monoxide in the atmosphere poisonous if inhaled, injected, or ingested. It has a high lethality, causing weakness,
 Structural fires in houses and buildings where victims are overcome by the fever, and pulmonary edema after inhalation that can lead to death from hypoxemia in 2
gradually spreading monoxide while trapped or asleep to 3 days. Following ingestion, the first symptoms of ricin poisoning usually occurs in
 When a drunken person collapses with a lit cigarette then the bed cover catches less than six hours. Death takes place within 36 to 72 hours of exposure, depending on
fire; the smoldering bed cover results in a high level of carboxyhemoglobin; and the route of exposure
 Many industrial processes that could lead to monoxide poisoning, especially in

iron and steel works, where producer gas and water gas are deliberately formed Ricin poisoning can occur through three channels:
and stored as part of the manufacturing process.  Inhalation - difficulty breathing, fever, cough, nausea, tightness in the chest,

heavy sweating, fluid building up in the lungs that makes breathing even more
THALLIUM difficult, the skin might turn blue; low blood pressure and respiratory failure
Thallium (Tl) is a soft gray metal mostly found geologically in potassium-based may occur, eventually leading to death
ores at the Earth's crust. It can also be commercially produced as a byproduct from the  Ingestion- vomiting, diarrhea that may become bloody, severe dehydration, low

refining of heavy metal sulfide ores, and used in the manufacture of electronic devices, blood pressure, hallucinations, seizures, blood in the urine; Within several
switches, the semiconductor industry, manufacture of special glass, and for certain days, the liver, spleen, and kidneys might stop working, and the person could
medical procedures. Thallium sulfate is an odorless, tasteless and highly toxic dense die
white powder salt that has been commonly employed as a rat poison. This sulfate salt  Skin and eye exposure - ricin in the powder or mist form can cause redness

is soluble in water and can enter the body by ingestion, inhalation, or through contact and pain of the skin and the eye
with the skin. It has been banned in several countries due to safety concerns. Thallium
disrupts many cellular functions and is also a suspected cause of carcinogen. Following
absorption, it is distributed to the red blood cells and also appears in the brain, lungs,
guts, muscle tissue, salivary glands, pancreas, testes, spleen, kidney, liver, and bone.
LEAD
Lead is a soft and malleable metal used in building construction, lead acid STIMULANTS
batteries, bullets and shots, weights, as part of solders, pewters, fusible alloys, and as a Stimulants (also called "uppers") are psychoactive drugs that stimulate the
radiation shield. nervous system, resulting in euphoria, increased energy and alertness with loss of
Lead acetate is the most common salt that causes acute poisoning. appetite. Effects may also include increased heart rate, blood pressure and respiratory
Immediately upon ingestion, the person will feel a sweet, metallic astringent taste in the rate; aggressive behavior and confused thinking leading to exhaustion and sleep, dry
mouth along with a burning sensation in the throat and stomach, salivation and intense mouth, sweating, dilated pupils and hyperactive reflexes; hallucinations, delusions and
thirst. Other symptoms include vomiting, constipation, cold clammy skin, feeble rapid paranoia; and even fits, coma, and death. Stimulants are widely used as prescription
pulse and shock, drowsiness, headache, muscular cramps and convulsions. Paralysis medicines for treatment of narcolepsy, obesity attentional disorders and clinical
of lower limbs may be seen, and death may occur. Chronic poisoning occurs among depression.
workers in factories where lead and its products (such as paint sprayers, compositors, Amphetamine is the most popular stimulant. It may be taken intravenously,
plumbers, enamel workers, glass blowers, electric light workers and lead ore refiners) orally or sniffed/ snorted, with effects coming on quickly and lasting for several hours.
are widely used. Food can also be contaminated when stored in vessels containing Other notable stimulants include caffeine (found in coffee, tea, cocoa, chocolate, soft
lead. Ground water, hair dyes and cosmetics can also be contaminated and can result drinks and energy drinks), nicotine (the active chemical constituent in tobacco),
in chronic lead poisoning due to absorption from the skin (Sharma, 2011). ephedrine (commonly used as a stimulant, appetite suppressant, concentration aid and
decongestant), and anabolic steroids (used for cosmetic purposes to develop and
DRUG ABUSE maintain masculine characteristics). Abuse of CNS stimulants can lead to insomnia and
Drug abuse is a growing global problem often resulting in accidents, criminal severe depression, as well as medical, psychiatric, and psychosocial deterioration.
activity and death. Drug-related crimes are usually committed either to fund the
purchase of drugs or as a consequence of drug misuse. Examples of such criminal COCAINE
activities include shoplifting or burglary; offenses under the various acts established to Cocaine is a strongly addictive controlled substance derived from the leaf of
control thepossession, distribution and consumption of drugs; and criminal acts carried the Erythroxylon coca bush. It has become an extremely popular drug with some
out by persons in an abnormal mental state due to drug intoxication or withdrawal, such medicinalvalue, although it also has a high potential for abuse. Cocaine in the form of
as assault or damage to property. white crystalline powder can be snorted intranasally or injected intravenously, while
The WHO defines a drug as "any substance, other than those required for the crack cocaine is the less expensive form that can be smoked. Injecting cocaine
maintenance of normal health, that, when taken into the living organism may modify produces the most rapid, almost immediate effects. Snorting results in a peak effect
one or more of its functions." within 30-120 minutes; while smoking effects peak within 5 minutes. The euphoric
Drug misuse is defined as "any taking of a drug which harms or threatens to effects wear off very quickly and therefore have to be quickly repeated. Larger doses or
harm the physical and mental health or social well-being of an individual, of other a "binge" may result in anxiety and panic leading to paranoia (Stark & Norfolk, 2009).
individuals, or of society at large, or which is illegal." Meanwhile, drug dependency is Cocaine makes the user feel euphoric, stimulated, and alert. It also results in
defined as "a state, psychic and sometimes also physical, resulting from the interaction difficulty sleeping, loss of appetite, increased heart rate and blood pressure, and
between a living organism and a drug, characterized by behavioral and other responses causes the body temperature to rise. Adverse effects include cardiovascular
that always include a compulsion to take the drug on a continuous or periodic basis in complications, psychosocial problems, and addiction resulting in powerful cravings to
order to experience its psychic effects and sometimes to avoid discomfort of its produce the desired effect. Chronic abusers develop dangerous psychological and
absence. Deaths related to drugs may be from recreational usage of illegal drugs or behavioral patterns, and even severe psychosis. Another unfavorable outcome of
from deliberate or inadvertent misuse of over-the-counter preparations or prescription cocaine intoxication involves an episode of bizarre behavior called "cocaine psychosis"
medications. or "excited delirium, " which manifests in hyperthermia (elevated body temperature),
delirium, paranoia, abnormally great strength, highly agitated state, cardiorespiratory
AN AUTOPSY CAN REVEAL THE FOLLOWING CLUES THAT A PERSON MAY arrest, and sudden death.
HAVE DIED OF A DRUG OVERDOSE (DOLINAK, 2005, P. 500):
 "Foam cone" over nose and/or mouth; ECSTASY
 Colorful discoloration of lips, tongue, oral mucosa or stomach; Ecstacy is the street name for Methylene dioxymethamphetamine (MDMA). It
 Granular, grainy, or pasty pill material in mouth and/ or stomach; • Pills instomach; is a "party drug" that is classified as both a stimulant and a hallucinogen. It is
• Pulmonary congestion and/or edema; administered orally as a tablet or capsule, and the effects last approximately three to six
 Frothy fluid in bronchi and trachea; hours. Its popularity in nightclubs and raves is due to its empathy-enhancing properties,
 Mucus in bronchi; and which increase a sense of intimacy and diminish anxiety with others, which can induce
 Increased amount of urine in urinary bladder. euphoria and mild psychedelia.
 High doses of MDMA can damage neurons, resulting in depression, anxiety, CANNABIS
memory loss, learning difficulties, sleep disorders, and sexual dysfunction. It can also Cannabis or marijuana is a tobacco-like greenish or brownish material made of
lead to an increase in heart rate and blood pressure, fainting, panic attacks, and, in the dried flowering tops and leaves of the cannabis (hemp) plant. It is usually smoked
severe cases, loss of consciousness and seizures. Although not commonly fatal, a or taken orally as "brownies, " and can make users feel pleasurably relaxed or euphoric.
potentially dangerous side effect is hyperthermia (an increase in body temperature), It has mood-altering properties and is addictive. When smoked, effects occur within a
which can lead to death. MDMA-related deaths have in fact increased markedly, few minutes and last up to one hour with low doses or 2 to 3 hours with higher doses. If
possibly due to its wide availability to young people, especially in parties and clubs. it is ingested, it may take an hour or more to have an effect which can last 12 hours or
more
METHAMPHETAMINE The active component in marijuana, which is tetrahydrocannabinol (THC),
Methamphetamine hydrochloride or "shabu" is a synthetic drug that comes as activates the brain's reward system in the same way that other drugs of abuse do and
a white odorless powder, tablet or as crystals that look like shards of glass with a bitter causes increased heart rate, dilation of the blood vessels in the whites of the eyes,
numbing taste. It can be swallowed, sniffed/snorted, smoked or injected, resulting in a relaxation and dilation of the bronchial passages, and euphoria.
feeling of physical and mental well-being, as well as a surge of euphoria and Other effects include dry mouth, excessive hunger and thirst, sleepiness, and
exhilaration. occasionally dysphoria (anxiety, fear, panic, and paranoia). Heavy use impairs memory
When smoked or injected, it produces an instantaneous "rush" and euphoria and attention. THC also impairs the areas of the brain that regulate balance, posture,
that can last anywhere from 4 to 12 hours. Effects from oral ingestion occur in around coordination of movement, and reaction time. Proof of the intake can be obtained from
30 minutes and 3 to 5 minutes from snorting. Effects may continue for up to 24 hours; analysis of urine, blood, and swabs from lips and fingers.
the half-life of the drug is 12 hours. Oral ingestion or snorting does not produce the Marijuana is the most widely used illicit drug in the world. It is not known to
"rush" . cause death via direct drug toxicity, but THC has been detected in a fairly significant
Methamphetamine abuse leads to effects similar to those of cocaine, such as number of deaths, particularly those due to overdose of other drugs and violent or
aggressive and violent behavior, auditory hallucinations, mood disturbances, delusions, accidental deaths. Studies have shown that THC alone impairs driving performance,
and psychotic and paranoid episodes that can result in homicidal and suicidal thoughts. and the effects are even greater when combined with alcohol .
Other potential adverse effects include cardiac and neurological problems,
hypertension, and stroke. If not treated immediately, methamphetamine overdose can DEPRESSANTS
lead to hyperthermia, which can result in death. CNS depressants (also called "downers" are drugs that slow brain function in
aprogressive manner and are most often used in the treatment of anxiety and sleep
HALLUCINOGENS disorders. These include sedatives, hypnotics (sleep inducing), and antianxiety drugs
Hallucinogens are drugs that alter the perception of reality. They rarely cause (tranquilizers). Depression of the nervous system leads to sedation and relief of anxiety
toxicity sufficient enough to result in death, but may cause convulsions, respiratory but, because of disinhibition, may initially result in euphoria, excitation, and risk-taking
depression, coma, hyperthermia, and seizures that may prove fatal. Psilocybin may Physical effects include disorientation, drowsiness, slurred speech, nystagmus,
cause coma and convulsions. In addition, the effect of altered perceptions, psychosis, loss of co-ordination, ataxia, coma, and death. They should not be used in combination
and bizarre behavior may lead to or contribute in some way to traumatic death. with other CNS-depressing drugs. At high doses, cerebral depression may occur; so
For example, an abuser under the influence of LSD may be under the the effects are more dangerous when taken with other cerebral depressants such as
impression that he can fly and thus project himself from a high window (Dolinak, 2005; alcohol
Saukko & Knight, 2004).
Examples of hallucinogens include LSD and cannabis, as well as PCP Among the most common CNS depressants are the following:
(phencyclidine, also called "angel dust"), mescaline (from the peyote cactus), and
psilocybin (from mushrooms).  Barbiturates - used to treat seizures, anxiety, tension and sleep disorders;
particularly dangerous drugs when taken in overdose and cause a physical and
LYSERGIC ACID DIETHYLAMIDE (LSD) psychological dependence;
Lysergic acid diethylamide (LSD) is a powerful hallucinogenic that is not fatal  Benzodiazepines - prescribed to treat anxiety, sleep disorders, and panic attacks
in itself. It is usually taken orally with sympathomimetic effects within 5 to 10 minutes (withdrawal syndrome includes the major complications of fits and psychosis)
and psychological effects within 30 to 60 minutes, depending on the dose taken. The  Ketamine - used as an anesthetic agent that can be taken intranasally, orally or by
effects can last for 8 to 12 hours with a recovery period of 10 to 12 hours. Visual effects injection (users can experience a cocaine-like "rush" with psychological
such as intensified colors and distorted shapes occur, as well as distortions of hearing dissociation).
ALCOHOL OPIODS
Alcohol (Ethanol) Ethanol is a colorless, flammable, volatile liquid that is soluble in Opioids are addictive and potentially deadly drugs, in which analgesic
water and has a characteristic taste and odor. It is commonly referred to simply as (painkiller) effects decrease the perception of pain and reaction to pain as well as
alcohol or spirits, and is the principal type of alcohol found in alcoholic beverages. It is a increase pain tolerance. They are also considered as strong cough suppressants. Side
product of fermentation by the action of yeast cells on sugars found in fruits and grains. effects include mental clouding, drowsiness, visual disturbances, sedation, constipation
A person's blood alcohol concentration (BAC) is directly linked to CNS and a strong sense of euphoria. Severe intoxication can result in respiratory depression
depression. Factors that determine BAC include the volume of alcohol consumed, and death.
whether consumption was with or without food, body weight, gender and distribution of Examples of opioids include morphine, heroine, codeine, methadone and
ethanol. other opiates. Morphine is the major representative of the general group of opioids,
Tolerance lessens the effectiveness of alcohol. Therefore, chronic alcohol which comprise natural opium and a whole series of chemically related derivatives.
users may appear to act normal or only slightly impaired despite having a high BAC. Heroin is the most abused and the most fatal; it has no medical use and a high potential
Highly tolerant alcohol users can be capable of engaging in physical activities and for abuse. The most common route of exposure is intravenous injection, but it can also
actions at levels that would result in unconsciousness or even death in non-tolerant be snorted or smoked. Side effects include severe itching, flushing, dry mouth, nausea
individuals (Stripp, 2007). and vomiting.
Deaths due to the toxic effects of acute over-ingestion of ethanol are due to In cases of fatal heroin abuse, a person may die suddenly, sometimes with the
severe respiratory and CNS depression. It can be caused either by the direct needle or the tourniquet still around the arm. Intravenous abusers may have a single
depressive effects or through secondary events such as aspiration of vomit. Lower scar from a favored injection site or have multiple needle tracks, usually in the veins of
alcohol intoxication can also be fatal if the ethanol is combined with an opiate or other the arm and hands. Other injection sites are the veins in the leg, groin and even the
types of depressant (Saukko & Knight, 2004; Dolinak, 2005). Alcohol-intoxicated neck. Heroin can also be volatilized and then inhaled by heating on a spoon, bottle cap,
persons are also often involved in fatal trauma triggered by their aggressive behavior. portion of a metal beverage can, or on a piece of tinfoil
Road accidents often involve alcoholic vulnerability, either caused by drunk drivers or
drunk pedestrians. POST-MORTEM FORENSIC TOXICOLOGY
In suspected drug and poisoning deaths, the pathologist collects and
OTHER FATAL INCIDENTS MAY OCCUR (SAUKKO & KNIGHT, 2004). preserves the specimens for toxicological analysis subsequent to the autopsy. These
cases usually involve toxicological scenarios, such as drug overdose, homicide by
 Falling down the stairs resulting in head injuries poison, alcohol impairment in an accident or crime, or use of drugs to commit suicide.
 Falling from high places due to drunken carelessness or unsteady gait Toxicological analysis is also required in determining if assertions of self-
 Burns and carbon monoxide poisoning (a common scenario is for a drunk to go to defense against drug-induced psychotic behavior are plausible, if drugs were used to
bed and fall asleep whilst smoking, the cigarette igniting the bedclothes. incapacitate a victim of a crime, or if a patient was in compliance with their prescribed
Sometimes, a gas, electric or kerosene heater may be knocked over during medicines. Sometimes, the cause of death is unknown, and the toxicologist has to
drunken staggering, which can also start a fatal fire) review the case history and investigation to narrow the search for a specific poison.
 Drowning especially in river or docking areas (e.g., falling from a bridge or
passageway into the water) SPECIMEN COLLECTION
Specimen selection, collection, and preservation play an enormously
GAMMA-HYDROXYBUTYRATE important role in toxicology. It is important to know which specimens are most useful for
Gamma-hydroxybutyrateor (GHB) is an anesthetic with primarily sedative yielding drug concentrations that are practical for interpretation. Furthermore, the
properties. It has been used as a bodybuilding drug and treatment to conditions such as proper specimen must be used to assemble all the pieces of the puzzle when trying to
insomnia, clinical depression, narcolepsy and alcoholism. It is also used as an determine a cause and manner of death.
intoxicant or as a date rape drug slipped into a drink by sexual predators, causing the The challenge with post-mortem samples is that the quality and availability of
victim to become incapacitated and develop amnesia. Clinical effects start within the samples themselves can vary greatly. Unlike testing clinical samples from living
10 to 15 minutes but the duration of action is unpredictable individuals, post-mortem toxicology has the unique problem of testing samples
GHB typically generates feelings of relaxation, euphoria and intoxication. collected at autopsy that may have undergone varying levels of decomposition. For
Lower doses cause drowsiness, dizziness, nausea, and visual disturbances; at higher example, decomposed bodies may no longer have blood, yet may have vitreous, urine,
dosages, unconsciousness, seizures, severe respiratory depression, coma, and death and tissue samples. The use of proper preservatives is important to prevent further
have been reported (Stripp, 2007). post-mortem changes in the samples. Even the selection of the container itself can be
important
  BLOOD is the most common and preferable sample to use, when possible. It is a often,concentration. A confirmatory test should be a different methodology from the
relatively easy sample to obtain and store. For post-mortem studies, peripheral screening test and should be run on a different sample/specimen, if possible
blood is more desirable than central blood as it is less affected by postmortem
redistribution. PRELIMINARY SCREENING TEST
 URINE can be used as a second sample for confirmation of a drug's presence. It Preliminary Screening Tests Screening tests allow the toxicologist to rapidly
is good as a screening sample as it tends to have less interfering substances, test for a variety of drugs and toxins. Screening tests give preliminary results, and then
and provides qualitative information on past a positive result must be verified with a confirmatory test.
 exposure or use. It is also relatively easy to obtain and store.
 VITREOUS is an excellent specimen to use in the absence of blood. It is less  Immunoassays are popular techniques that can be used to screen a large number
subject to contamination, is not affected by embalming, and demonstrates good of drugs. The methods are relatively fast and straightforward to use.
stability. Vitreous is an excellent specimen for water soluble substances, Immunoassays use antibodies that bind with a target class of compounds (in
including ethanol and barbiturates. this case, drugs). The antibody binds to the drug in question, thereby yielding a
 BILE is usually not a first-line specimen but can be useful in qualitative screening. positive screen if the drug is present.
Bile is not always present, and when it is available, it is usually in limited  Spectrophotometry is easy to use but it is not commonly used in forensic
quantities. It is most often used for detecting opiates and morphine. toxicology because of its lack of sensitivity and specificity. A spectrophotometer
 TISSUE SPECIMENS are commonly collected at autopsy and are readily can measure the changes in the wavelength of light (ultraviolet or infrared)
available in large quantities. However, interpretation of drug concentration can passing through a substance to determine the presence or absence of certain
be difficult since data is not often available for comparison. Tissue molecules within the matrix.
concentrations may also be elevated in oral overdoses and chronically  Chromatography can be used as a screening test for a large number of drugs
administered drugs. Muscle is a preferred tissue sample. Liver can be used as when combined with a detector. Gas chromatography (GC) and liquid
a secondary sample when blood is not available; there is extensive data chromatography (LC) are very popular in forensic toxicology, because they are
available for comparison of post-mortem drug concentrations. Kidney specimen easy to perform, sensitive, and can provide good initial separations. Drugs are
is used mainly in heavy-metal testing; lung specimens for inhaled toxins, such dissolved into a mobile (gas or liquid), which is then passed through a
as volatile substances; spleen for cases of carbon monoxide poisoning; and stationary phase allowing for separation and isolation of the constituents of the
adipose tissue for pesticide poisonings and volatile analysis. sample. The time taken to traverse the stationary phase is recorded by a paired
 STOMACH CONTENTS are often collected in cases where an oral drug overdose detector and compared to an internal standard, thus facilitating the detection of
is suspected. Odors may be present that give a clue of agents present. each component within the sample phase
 HAIR is an excellent screening source for arsenic poisoning and is becoming
more commonly used in screening for the chronic use of illicit drugs, including CONFIRMATORY TESTS
morphine, cocaine, and amphetamines. Drugs can be deposited in hair as it The process of confirmation involves the use of various methods that give
grows, allowing hair samples to yield information about drug intake over a structurally specific information about a compound in order to eliminate the potential for
period of several months to years, depending on the length of hair sampled. false positive results. When a drug has been identified by one of the screening tests,
 Other samples include fly larvae (maggots), blood stains, soil samples and confirmatory tests should be performed using a different methodology than the
cremation ash, which may contain drugs or poisons. Tablets, capsules, vials, screening test and on a different sample, if possible (or at least a different extract of the
and various household products may also be collected at the death scene. same sample).
The confirmatory test should also be more specific than the screening test.
LABORATORY ANALYSIS The popular method is GC or LC paired with mass spectrometry. Mass spectrometry is
Once the samples have been collected and properly preserved, the next step accomplished by fragmenting a molecule using a barrage of electrons and then
is called the extraction procedure, which involves the separation of the analytes (the analyzing the relative abundance of the fragments or by ionizing molecules and
substances you want to measure) from the biological matter. Most specimens require a analyzing the charge transference (Molina, 2010).
certain degree of pretreatment to isolate the drug or poison by using separation
techniques such as distillation, protein precipitation, liquid-liquid extraction and solid-
phase extraction.
This is followed by forensic toxicological analysis using two types of tests:
screening tests and confirmatory tests. Samples are usually first screened for the
presence of medications and/or intoxicating substances, then a more specific,
confirmatory test is performed to determine the exact substance and,