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Postmortem Toxicology of Abused Drugs

2007 Edition, October 9, 2007

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Active, Most Current

EN
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ISBN: 978-1-4200-5451-4
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Product Details:

  • Revision: 2007 Edition, October 9, 2007
  • Published Date: October 9, 2007
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 214
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:

Preface

Because of the continuous increase in availability and use of pharmaceuticals and illicit drugs, postmortem toxicology has become more and more important in death investigations. The introduction of new substances to the market requires a high awareness among pathologists and toxicologists and necessitates the development of methods that encompass the newcomers. Fortunately, many important achievements have been made in methodology, and the application of novel techniques, such as modifications of solid phase extraction and LC/MS techniques, now offers better conditions for efficient and sensitive analyses of numerous substances.

Many important contributions regarding the impact of various postmortem changes that may influence the toxicological results have been published. Pharmacogenetic analyses, e.g., to identify poor metabolizers, may now be applied on postmortem material and assist in the determination of the manner of death, and studies on postmortem redistribution of drugs have resulted in a widespread appreciation of the influence of the specimen type on the drug concentrations.

In recent years, the specific detection of many compounds and their metabolites in various matrices has improved substantially. However, the interpretation of their concentrations remains a difficult task. Hence, despite the progress in postmortem toxicology, information about previous drug use and the circumstances surrounding death, and the autopsy findings are still very important in order to arrive at correct conclusions when interpreting the analytical results. An intimate collaboration between toxicologists and pathologists is therefore desirable.

Traditionally, teachers of forensic science have always emphasized that the proper investigation of a drug-related death involves three elements: scene investigation, autopsy, and toxicological examination. The traditional approach is no longer valid because it assumes that the autopsy was complete. We now know that it has never been complete. Heart disease is not ruled out just because 25 sections of myocardium look normal. Poisoning is not proven just because blood morphine concentrations are very high. We now live in the age of the DNA microarray. Chips for measurement of CYP2D6 polymorphisms are already available commercially. Arrays for the measurement of the hundreds of genes involved in hypertrophic cardiomyopathy already exist in development labs. The sooner these new technologies are incorporated into forensic toxicology, the sooner the justice system will benefit.