Forensic Toxicology

Question 1

What three types of death have to be reported to the coroner under section 3 of the Coroner’s act 1887?

Answer 1

1. Violent
2. Unnatural or sudden
3. Cause of death is unknown

Question 2

What are the most common drugs of abuse and why?

Answer 2

• Ethanol - over dose, accidents includings RTCs
• Heroin - IV injection, fatal OD, respiratory depression or aspiration pneumonitis, people build up a tolerance
• Methadone - tolerance
• Benzodiazepines - respiratory depression, rare to cause death alone
• Cannabis - never fatal alone, can lead to RTAs
• Cocaine - injected with heroin causing ‘speedball’, tolerance, acute dangers include cardiac dysrhythmias, acute heart failure and MI
• Amphetamines/stimulants - MDMA, large OD can cause direct toxic effect on heart

Question 3

Name 4 ‘legal highs’/’designer drugs’/New psychoactive substances and their effect

Answer 3

• stimulants (cathinones)
• synthetic cannabinoids or spice
• synthetic opiods e.g. acetylfentanyl
• hallucinogenic compounds e.g. 1P-LSD

Question 4

What is the difficulty with detecting cocaine use/potential cause of death in a post mortem?

Answer 4

• Cocaine degrades in post-mortem blood. Therefore post mortem concentration and concentration at time of death are not the same
• In order to interpret cocaine other things are needed, witness behavior, cardiovascular pathology and medicinal/drug use history
• Addicts can tolerate high levels

Question 5

Why is hair important in analysis?

Answer 5

• Blood/serum, drugs typically can be detected for no more than 12 hours
• Urine, drugs typically detected for 2-3 days
• Hair is the only specimen that can give information about long term drug use
• drugs are incorporated into hair from the blood stream during the growth phase
• hair growth is approx 1cm/month and is like a ‘tape-recording of drug use’
• drugs such as analgesics, anticonvulsants, antiemetics etc are all detectable in the hair

Question 6

What are the problems with hair analysis?

Answer 6

• Environmental contamination
• Absorbed from sweat or sebum coating hair
• Passive inhalation
• Cosmetic treatment - shampoo washing
• Hair colour