Detection of drugs in human hair using Abbott ADx, with confirmation by gas chromatography/mass spectrometry (GC/MS).

The authors suggest use of the fluorescence polarization immunoassay (FPIA) technique in evaluation of chronic drug abuse using human hair. Hair was decontaminated in 5 mL of ethanol for 15 min at 37 degrees C and then incubated in 3 mL of 1M sodium hydroxide (NaOH) for 1 h at 100 degrees C. Afterwards, the aliquots were neutralized and analyzed using Abbott ADx for a negative or positive response for the following drugs: benzodiazepines, barbiturates, antidepressants, opiates, cocaine, amphetamine, and cannabis. All the positive samples were confirmed by gas chromatography/mass spectrometry (GC/MS). Only one false positive was detected (caused by interference of a phenothiazine with the antidepressants kit), clearly demonstrating the capability of ADx for toxicological screening of human hair.     

Gas chromatography with mass-selective detector in testing blood for amitriptyline and nortriptyline

The article describes the method of simultaneous detection of amitriptiline and nortriptilin in cadaveric blood using gas chromatography with mass-selective detection. Preparation includes liquid-liquid extraction and derivation with trifluoroacetic anhydride. Nortriptilin threshold of detectability in the blood is 0.02 mcg/ml, amitriptilin one--0.05 mcg/ml. The range of detectability--0.05-3.0 mcg/ml for both compounds. Maximal error of the compounds detectability was under 12.9% for concentrations 0.10 mcg/ml and 10.6% for concentrations 2.0 mcg/ml. The method was tested on expert material in forensic chemical examinations.     

A rapid method of isolating a phenothiazine derivatives from cadaveric specimens

Proximate method for isolation of 10 psychotropic compounds of phenothiazine series from the cadaveric material was developed using acetonitrile with subsequent extraction of these derivatives by ether at pH 13.0 and reextraction by 0.5 n. solution of sulfuric acid. Method of isolation by acetonitrile shortens time for analysis by 5-6 times as compared with modified Stas-Otto method suggested previously for this purpose.     

Antidepressants at Autopsy in Hispanic Suicidal Youth in Miami‐Dade County,Florida*

Abstract: Controversy has surrounded the use of antidepressants and suicidal behaviors in youth. This study reviewed the Medical Examiner’s Office records of 253 persons aged 24 years or younger classified as suicides in Miami‐Dade County, Florida, from 1990 to 2007. Information was collected regarding demographic information, suicidal characteristics, psychiatric and psychosocial factors, and toxicology results. Eighty‐five percent of the sample was men, and 53.4% of the subjects were Hispanic. Consistent with previous literature, the existence of antidepressants at autopsy was rare; present in only 6% (n = 15) of the victims. The occurrence of antidepressants was not significantly different between Hispanics (n = 7) and non‐Hispanics (n = 8). The incidence of antidepressants was weakly correlated with a tendency to be men and no history of psychiatric illness. The presence of antidepressants in Hispanic youth suicide victims was similar to non‐Hispanics.     

Evaluation of sudden death in psychiatric patients with special reference to phenothiazine therapy: forensic pathology

The investigation of sudden unexpected death in psychiatric patients and the ensuing litigation has brought to our attention many unusual features important in the evaluation of such deaths. Certain pathophysiologic mechanisms of death, rarely encountered in routine forensic science practice, may be important in determining the cause of death in psychiatric patients, especially in cases where the autopsy is unrevealing. Of particular concern is a tendency in the current literature to implicate phenothiazines as a cause of death when the death investigation and the autopsies are incomplete. Thus, based on our experience and on a review of the current literature, we have set forth factors that the forensic pathologist should consider when faced with a sudden psychiatric death. A case report illustrates these unique aspects of scene investigation and analysis of terminal events and autopsy findings.     

Brain distribution of selected antipsychotics in schizophrenia

The brain distribution of phenothiazine antipsychotics in 22 confirmed schizophrenic and 11 control subjects were collected at autopsy. Specimens were homogenized, extracted with n-butyl chloride, and analyzed via liquid chromatography-mass spectrometry, using atmospheric pressure electrospray ionization operating in the positive mode. Drug concentrations normalized for those observed in cerebellum showed three distinct patterns of distribution corresponding to different structural features of each type of phenothiazine. Those drugs with high affinity for dopamine receptors were detected in the highest concentrations in regions with high concentrations of such receptors. However, those associated with relatively lower dopaminergic activity were found in the highest concentration in the occipital cortex, a region with a relatively low concentration of dopamine receptors. The regional brain distribution of thioridazine and its metabolites was concentration dependent. These results have implications for determining the role of these drugs in the sudden and unexpected deaths of schizophrenics.     

Medicines and psychoactive agents in traffic users—the medico-legal problem in Poland

The increasing number of traffic accidents connected with rapid development of motorization makes us think of their causes. Regulations by law binding in Poland demand traffic users to be checked up on the presence of agents similar ethyl alcohol. Commonly abused medicines, especially sedative and psychotropic but also hypnotic and analgesic are a great traffic problem. Up to the present analytical procedures and a model medico-legal opinion on the influence of medicines on psychophysical efficiency have not been standardised.In the paper the authors have presented the results of their research on agents negatively influencing the human psychophysical efficiency carried out in the Forensic Medicine Department, Silesian University of Medicine, Katowice. The research comprised individuals involved in both traffic crashes and accidents who (as checked) either where not under the influence of ethyl alcohol or the concentration of ethanol was low (1‰). Positive cases most often showed only one sort of medicines (barbiturates, benzodiazepines or opiates). In other cases barbiturates and benzodiazepines, benzodiazepines and opiates as well as derivatives of benzodiazepine and tricyclic antidepressants were determined. Blood concentrations of all these substances were in a wide range of therapeutic doses.     

Police interrogation practice in Slovenia

Interrogation techniques are well explored, but in Slovenia it has remained unknown what interrogation techniques are used and what the basic characteristics of suspect interrogations are. The Slovenian interrogation manual proposes some coercive interrogation techniques and neglects their weaknesses. The aim of the current study was to examine Slovenian police officers’ beliefs as to the basic characteristics of their interrogations and whether techniques proposed by the manual are used in practice to begin to provide some insight into what actually happens in such interrogations. A survey instrument was used to obtain self-report data from a sample of criminal investigators. From 86 completed questionnaires it was found that a typical interrogation of a suspect lasts around 90 minutes and is not recorded. Interviewers typically use three interrogation techniques namely (i) conducting interrogations in isolation; (ii) identifying contradictions in the suspect's story; and (iii) confronting the suspect with evidence. Findings suggest that some coercive interrogation techniques are used in practice (e.g. offering moral justifications, alluding to have evidence of guilt, good cop/bad cop routine, and minimization). The study is the first insight into the practices of Slovenian investigators when questioning suspects. Differences among general, white-collar and organized crime investigators are also discussed.     

Concentrations of Opiates and Psychotropic Agents in Polydrug Overdoses: A Surprising Correlation Between Morphine and Antidepressants

Abstract: The relationship between postmortem concentrations of morphine and co‐detected psychoactive drugs in fatal overdoses is examined. Morphine and other drugs were detected in 161 medicolegal autopsy cases. Subsets of these morphine‐positive cases based on drug class were established, including opioids, antidepressants, ethanol, benzodiazepines, and “other.” Each subset was split into high or low concentration groups based on median drug concentrations. Morphine concentrations of the [high] and [low] groups were compared, with no significant difference in morphine concentration identified in the opioid, ethanol, or benzodiazepine subsets. The “other” drug class was too heterogeneous for statistical assessment. Morphine concentrations did show a significant direct relationship (p = 0.01) with antidepressants, namely increased concentrations of antidepressant drugs are associated with an increased concentration of morphine. This trend probably remains even after excluding cocaine‐positive cases. The unsuspected finding that postmortem concentrations of antidepressants positively correlate with morphine levels may be important in the treatment of depression in drug addicts.     

Use of headspace solid-phase microextraction (HS-SPME) in hair analysis for organic compounds

Headspace solid phase microextraction (HS-SPME) has advantages of high purity of the extract, avoidance of organic solvents and simple technical manipulation and can be used in combination with gas chromatography-mass spectrometry (GC-MS) in the hair analysis of a number of drugs. HS-SPME coupled with the hydrolysis of the hair matrix by 4% sodium hydroxide in the presence of excess sodium sulphate and of a suitable internal standard proved to be a convenient one-step method for the measurement of many lipophilic basic drugs such as nicotine, amphetamine derivatives, local anaesthetics, phencyclidine, ketamine, methadone, diphenhydramine, tramadol, tricyclic antidepressants and phenothiazines. Detection limits were between 0.05 and 1.0 ng/mg. From spiked 10-mg hair samples absolute recoveries between 0.04 and 5.7% were found. These recoveries decreased considerably if larger sample amounts were used, perhaps due to increased drug solubility in the aqueous phase or to elevated viscosity in the presence of dissolved hair proteins. Because of the phenolic hydroxyl group a change of pH after alkaline hair digestion (by adding excess orthophosphoric acid) was necessary for the detection of delta 9-tetrahydrocannabinol (delta 9-THC), cannabinol (CBN) and cannabidiol (CBD) by HS-SPME. Nevertheless, the detection limits were such that only CBN could be detected in hair of a consumer. Clomethiazole, a compound hydrolysed in alkali, was measured by HS-SPME after extraction with aqueous buffer. The detection limit was 0.5 ng/mg. Cocaine could not be detected by HS-SPME. The application of HS-SPME to hair samples from several forensic and clinical cases is described.     

Chromophoric labeling of cannabinoids with 4-dimethylaminoazobenzene-4'-sulfonyl chloride

A simple and sensitive assay for the cannabinoids is presented using a dabsylation procedure. Dabsyl derivatives of delta 9-tetrahydrocannabinol (delta 9-THC) and cannabinol (CBN) were prepared by reacting with 4-dimethylaminoazobenzene-4'-sulfonyl chloride (dabsyl chloride) in acetone in the presence of sodium carbonate-sodium bicarbonate buffer (pH 10). Crystalline dabsylcannabinoids gave intense absorption in the visible region. With these derivatives, analysis by thin-layer chromatography (TLC) and high performance liquid chromatography (HPLC) were tested. These techniques gave good separation and nanogram detection of dabsyl-THC and -CBN by using n-hexane-ethyl acetate-diethylamine (20:5:1) for TLC and MeOH--H2O (95:5) at 450 nm for HPLC.     

A Metric Comparison of Predictive Hot Spot Techniques and RTM

There are numerous hot spot mapping techniques that can be used in research and in practice for predicting future crime locations. Due to differences in the varying techniques, metrics were developed to compare the accuracy and precision of these techniques. The predictive accuracy index (PAI) and recapture rate index (RRI) were used to assess six different hot spot techniques. Spatial and Temporal Analysis of Crime, Nearest Neighbor Hierarchical, Kernel Density Estimation, and Risk Terrain Modeling were the general techniques compared in relation to their PAI and RRI values for short-term and long-term prediction of robberies. The results of the study were discussed with an emphasis on the utility of using multiple techniques jointly for analysis.     

Identification of 3,4-methylenedioxyamphetamine analogs encountered in clandestine tablets

Recently, 3,4-methylenedioxyamphetamine derivatives have been encountered in the Italian illicit market, mainly in form of tablets. Among this class of substances small modifications of the molecule may result in a wide range of derivatives and analogs some of which are not yet listed as controlled substances in the Italian schedules. Due to the structural similarity some of these molecules have a gas chromatographic behavior and mass spectra that only slightly differ. In the present work, an analytical strategy is proposed to achieve the identification of analogs within this class of molecules. In seized material sent by the Court of Law of Rome to our laboratories a number of tablets engraved with different symbols (e.g., `Dollar', `Fido Dido' and `Bomb') were submitted to analysis in order to establish whether they contained drugs of abuse. The analytical techniques employed for this purpose were UV spectrophotometry and thin-layer chromatography which provided information suggesting that the tablets contained a methylenedioxyamphetamine. Gas chromatography with flame ionization detection indicated that the main ingredient differed from the molecules of the same class already known. Finally, capillary gas chromatographic–mass spectrometric analysis of the native molecules and their pentafluoropropionic acid derivatives, performed with both, electron impact and chemical ionization, allowed the identification, in each tablet, of three molecules: the N-methyl-1-(3,4-methylenedioxyphenyl)-2-butanamine (MDP-2-MB, MBDB), the 1-(3,4-methylenedioxyphenyl)-2-butanamine (MDP-2-B) and the N,N-dimethyl-1-(3,4-methylenedioxyphenyl)-2-butanamine (MDP-2-MMB).     

Occurrence of barbiturate, benzodiazepine, meprobamate, methaqualone and phenothiazine in car occupants killed in traffic accidents in the south of Sweden

An investigation of the following psychoactive drugs: barbiturate, benzodiazepine, meprobamate, methaqualone and phenothiazine, was performed on all automobile occupants killed in accidents in southern Sweden during 1977 and 1978. Of 122 drivers and 55 passengers analysed, low concentrations of these drugs were found in nine drivers and in five passengers. Thus, 7.3% of the drivers were driving under the influence of drugs and, of these, two drivers (1.6% of all analysed drivers) were also inebriated. Twenty-three per cent of the drivers were inebriated only. According to the circumstances in the accidents and the number of drivers whose analyses proved positive, drug influence seldom seems to be the cause of fatal traffic accidents.     

自动固相萃取法(SPE)提取常见安眠镇静药

目的为筛选检验血、尿中未知安眠镇静药和三环抗忧郁药建立一种简便、快速的自动固相萃取方法。方法采用美国Zymark公司的自动固相萃取仪和Waters公司的OasisHLB固相萃取柱,同步提取血、尿中的25种常见安眠镇静药(包括巴比妥类、苯二氮卓类、吩噻嗪类药物等)和三环抗忧郁药。结果尿中药物提取率大部分达到80%以上;血中药物提取率在75%以上。结论该方法具有提取过程自动化,操作简便快捷,提取回收率高、重现性好、提取物干净等特点,可用于实际案件中血、尿中未知安眠镇静药和三环抗忧郁药的提取检验。     

血、尿中常见吩噻嗪类药物的高效液相色谱分析

吩噻嗪类安眠镇静药物易受光、热分解,气相色谱分析法受一定限制。而采用反相离子对液相色谱技术,使七种常见吩噻嗪类药物得到较好的分离。使用紫外及荧光分光光度计测定,可作为血、尿中此类药物的快速定性、定量分析方法之一。本法已在刑事中毒案件与临床抡救化验中应用。     

UNDERSTANDING CONFLICT AND HUMAN CAPACITY The Role of Premises in Mediation Training

In this article, the authors points out that underlying mediator practices and techniques, there are deeper premises and values that guide and shape practice. The authors argue that mediation training should include articulation and explanation of the premises that underlie the form of practice being taught. They describe the particular premises that underlie the transformative orientation to mediation practice and give examples of how those premises can be conveyed within an overall training design, how doing so enriches the teaching of skills and techniques themselves.     

The prevalence of drugs in injured drivers

In mid 2009 Victoria introduced compulsory drug testing of blood taken from all injured drivers taken to hospital. Δ(9)-Tetrahydrocannabinol (THC), methylamphetamine (MA) and 3,4-methylenedioxy-methylamphetamine (MDMA) are prohibited and if drivers are positive to any amount an automatic penalty is enforced. Laboratory screens were conducted on preserved blood using ELISA testing for cannabis metabolite and methylamphetamines and a fully validated LC-MS/MS method for 105 drugs including THC, amphetamines, opioids, benzodiazepines, antidepressants and antipsychotics and a number of other psychoactive substances using a minimum of two transitions per drug. Conventional GC-testing for ethanol was used to screen and quantify the presence of alcohol. 1714 drivers were tested and showed alcohol in 29% (≥ 0.01 g/100mL) and drugs in 35%. The positive rate for the three drugs prohibited by legislation was 12.5%. The prevalence of THC, MA and MDMA was 9.8%, 3.1%, and 0.8%, respectively. The range of THC concentrations in blood was 2-42 ng/mL (median 7) of which 70% had a concentration of 10 ng/mL or higher. The range of concentrations for MA and MDMA was 0.02-0.4 and 0.03-0.3mg/L (median for both drugs was 0.05 mg/L). Drugs of any type were detected in 35% of cases. The other drugs were largely prescribed drugs such as the antidepressants (9.3%) and benzodiazepines (8.9%). Neither 6-acetylmorphine nor cocaine (or benzoylecgonine) was detected in these cases.