Frederick P. Smith

Death from heroin overdose: findings from hair analysis

BACKGROUND Morphine analysis of hair is used in forensic toxicology to study the addiction history of heroin addicts. To clarify the features underlying fatal heroin intake, we measured hair morphine content in a group of deceased heroin addicts, to verify a possible correlation between fatal heroin overdoses and the addiction behaviour of these individuals before death. METHODS 91 deaths were attributed to heroin overdose in Verona, Italy, in 1993-96. We analysed the hair of 37 of these individuals, and of 37 active heroin addicts, 37 former heroin users abstinent from the drug for several months, and 20 individuals with no evidence of exposure to opioids. From each individual, a hair sample of about 150 mg was analysed by RIA and high-performance liquid chromatography, to measure the morphine content. FINDINGS The mean morphine content in the hair of the addicts who had died was 1.15 ng/mg (SD 2.35 ng/mg; range 0-12.25 ng/mg) compared with 6.07 ng/mg (4.29; 1.15-17.0) in the active heroin addicts, 0.74 ng/mg (0.93; 0.10-3.32) in the abstinent former addicts, and values below the detection limit in the non-exposed group. Hair morphine content among those who had died was significantly lower than that in active heroin consumers (p<.00001), but not significantly different from that in the former addicts (p=0.978). INTERPRETATION Although our findings may be subject to selection bias, since suitable hair samples were available for only 37 of the 91 addicts who had died, these findings support the theory of high susceptibility to opioid overdose after periods of intentional or unintentional abstinence, due to loss of tolerance. Medical staff running detoxification programmes should be aware of the risk inherent in relapse to heroin after a period of abstinence. Moreover, occasional heroin use without a build-up of tolerance could also give a high risk of overdose.

Detection of Phenobarbital in Bloodstains, Semen, Seminal Stains, Saliva, Saliva Stains, Perspiration Stains, and Hair

Low nanogram quantities of phenobarbital were detected in a 10-μL dried blood stain and in other physiological fluids by using radioimmunoassay. The age of the stain versus detectability of phenobarbital and the cross-reactivity of vaginal secretions were investigated.

Detection of Cocaine Metabolite in Perspiration Stain, Menstrual Bloodstain, and Hair

Low nanogram and picogram quantities of cocaine metabolite equivalents were detected in extracts from perspiration stains, menstrual bloodstains, and hair using radioimmunoassay. The theory of drug inclusion in hair and its significance are discussed.

Optimization of a simple method for the chiral separation of phenethylamines of forensic interest based on cyclodextrin complexation capillary electrophoresis and its preliminary application to the analysis of human urine and hair

Because of the forensic importance of the chiral analysis of amphetamine and other phenethylamines for investigating their synthetic pathways and the metabolic patterns of these compounds, a capillary electrophoresis method has been developed based on the chiral selectivity of beta-cyclodextrin. The influence of different experimental conditions, such as cyclodextrin nature and concentration, voltage, temperature and buffer concentration and pH, on analytical performance has been studied. The optimized analytical conditions are: capillary: bare fused silica, 50 microns I.D., 40 cm effective length; buffer: 150 mM phosphate pH = 2.5, 15 mM beta-cyclodextrin; voltage: 10 kV; temperature: 17.5 degrees C; detection: UV absorption at 200 nm wavelength. Under these conditions, amphetamine, methamphetamine and ephedrine have been easily separated, with baseline resolution of the respective enantiomers. Sensitivity was better than 300 ng per ml. The average precision of migration times of the three analytes was good with RSD = 0.45% and 0.58% in intra-day and day-to-day tests, respectively. Reproducibility of peak heights was also good, with RSD = 2.51% and 3.14% in intra-day and day-to-day tests, respectively. The preliminary analysis of amphetamine in human urine and hair samples, subjected to a simple work-up procedure based on liquid-liquid extraction, showed clean blank electropherograms, excellent chiral resolution and sensitivity, suitable for the analysis of real samples from amphetamine users.

Cocaine in hair, saliva, skin swabs, and urine of cocaine users' children

The concentrations of cocaine and benzoylecgonine (BE) in the hair, saliva, skin secretions, and urine samples of cocaine-using mothers, their children, and other adults living in the same environment were compared. Subjects were screened from urban cocaine dependence treatment patients. Drug using adults had mean hair concentrations of 2.4 ng cocaine/mg hair (range = 0-12.2, sigma = 3.1, 15/16 positive) and 0.39 ng BE/mg hair (range = 0-1.9, sigma = 0.62), compared with childrens mean hair concentrations of 2.4 ng cocaine/mg of hair (range = 0-14.4, sigma = 3.8, 22/24 positive) and 0.74 ng benzoylecgonine/mg hair (range = 0-5.4 sigma = 1.3). None of the childrens urine specimens (0/22) were positive above 300 ng BE/ml. In contrast, 3/16 adult urine specimens were positive, even though they were enrolled in drug treatment. Saliva had detectable levels of BE for only one child (1/17) and one adult (1/17). Forehead swabs contained measurable quantities of cocaine for most children (19/26) and adults (15/17) and BE for children (7/26) and adults (7/17). Unlike urine results, overall hair cocaine concentrations for adults paralleled those of children and a clear cut-off concentration could not be established to differentiate these two groups.

Determination of illicit and/or abused drugs and compounds of forensic interest in biosamples by capillary electrophoretic/electrokinetic methods

The application of capillary electrophoresis (CE) methods in forensic toxicology for the determination of illicit and/or misused drugs in biological samples is reviewed in the present paper. Sample pretreatments and direct injection modes used in CE for analysis of drugs in biological fluids are briefly described. Besides, applications of separation methods based on capillary zone electrophoresis or micellar electrokinetic chromatography with UV absorbance detection to (i) analysis of drugs of abuse, (ii) analysis of other drugs and toxicants of potential forensic interest and (iii) for metabolism studies are reviewed. Also, alternative CE methods are briefly discussed, including capillary isotachophoresis and separation on mixed polymer networks. High sensitivity detection methods used for forensic drug analysis in biological samples are then presented, particularly those based on laser induced fluorescence. A glimpse of the first examples of application of CE-mass spectrometry in forensic toxicology is finally given.

Complementary use of capillary zone electrophoresis and micellar electrokinetic capillary chromatography for mutual confirmation of results in forensic drug analysis.

The purpose of this work was to compare different CE separation modes namely capillary zone electrophoresis (CZE) and micellar electrokinetic capillary chromatography (MECC) for the analysis of drugs of forensic interest in order to assess the mutual degree of independence and consequently the possibility of complementary use for mutual confirmation of results. A panel of drugs including caffeine, morphine, barbital, pentobarbital, codeine, nalorphine, lidocaine, procaine, heroin, flunitrazepam, acetylcodeine, papaverine, amphetamine, narcotine, cocaine, diazepam, tetracaine, narceine, 6-monoacetylmorphine acetylcodeine and thebaine, were separated according to a MECC and two CZE methods. The MECC separation was carried out in a bare silica capillary (50 micron I.D.) with a buffer composed of 25 mM borate (pH 9.24)--20% methanol--100 mM sodium dodecyl sulphate; the applied voltage was 20 kV. The first CZE method (CZE1) was carried out in 50 mM phosphate buffer (pH 2.35) at 20 kV with a bare silica capillary (50 micron I.D.), and the second (CZE2) with 50 mM borate (pH 9.24) at 12 kV with the same capillary. The three methods were effective in the separation of the test drug mixture, but MECC was the only able to resolve all the components. Relative (to flunitrazepam), migration time RSDs ranged from 0.3 to 2.8% for the three methods were compared with Spearmans test and with principal component analysis, CZE1 and CZE2 were significantly and directly correlated (r = 0.749, p < 0.002), whereas MECC and CZE2 were also significantly, but inversely correlated (r = -0.865, p < 0.001). MECC and CZE1 (limitedly to the basic drugs) appeared non-correlated (r= -0.131, p = 0.630) and therefore the two techniques are suitable for combined use to increase the discriminatory power.

Chromatographic and electrophoretic approaches in ink analysis

Inks are manufactured from a wide variety of substances that exhibit very different chemical behaviors. Inks designed for use in different writing instruments or printing methods have quite dissimilar components. Since the 1950s chromatographic and electrophoretic methods have played important roles in the analysis of inks, where compositional information may have bearing on the investigation of counterfeiting, fraud, forgery, and other crimes. Techniques such as paper chromatography and electrophoresis, thin-layer chromatography, high-performance liquid chromatography, gas chromatography, gel electrophoresis, and the relatively new technique of capillary electrophoresis have all been explored as possible avenues for the separation of components of inks. This paper reviews the components of different types of inks and applications of the above separation methods are reviewed.

Cocaine detection in a university population by hair analysis and skin swab testing.

The ability to detect cocaine use/exposure by either hair or sweat analysis was compared in a random population of adults at a major US university. Sweat was obtained by wiping the forehead with a cosmetic puff containing isopropanol. Using cut-off levels for sweat of 2.2 ng cocaine/wipe and of hair of 0.05 ng cocaine/mg hair, sweat detected two times more cocaine use/exposure than did hair. Sweat analysis detected a use rate of 12% compared to a 6% rate by hair analysis, both greater than the 2% that would be expected in this population. The high rate of detection was surprising and suggests that use of, if not exposure to, cocaine is underreported. Controlled experiments showed that cocaine could remain on the skin for about 3 days after external exposure. At the current state of knowledge, sweat appears to measure both use and exposure. Nevertheless, sweat testing could be used in several scenarios (such as roadside driving while intoxicated) where the case of collection and testing of sweat could outweigh the passive exposure considerations. Cocaine concentrations in skin swabs > 15 ng/swab would appear to indicate recent use/exposure.

Hair analysis, a novel tool in forensic and biomedical sciences: new chromatographic and electrophoretic/electrokinetic analytical strategies

Hair analysis for abused drugs is recognized as a powerful tool to investigate exposure of subjects to these substances. In fact, drugs permeate the hair matrix at the root level and above. Evidence of their presence remains incorporated into the hair stalk for the entire life of this structure. Most abusive drugs (e.g. opiates, cocaine, amphetamines, cannabinoids etc.) and several therapeutic drugs (e.g. antibiotics, theophylline, beta 2-agonists, etc.) have been demonstrated to be detectable in the hair of chronic users. Hence, hair analysis has been proposed to investigate drug abuses for epidemiological, clinical, administrative and forensic purposes, such as in questions of drug-related fatalities and revocation of driving licences, alleged drug addiction or drug abstinence in criminal or civil cases and for the follow-up of detoxication treatments. However, analytical and interpretative problems still remain and these limit the acceptance of this methodology, especially when the results from hair analysis represent a single piece of evidence and can not be supported by concurrent data. The present paper presents an updated review (with 102 references) of the modern techniques for hair analysis, including screening methods (e.g. immunoassays) and more sophisticated methodologies adopted for results confirmation and/or for research purposes, with special emphasis on gas chromatography-mass spectrometry, liquid chromatography and capillary electrophoresis.