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Forensic testing for drugs of abuse in hair has become a useful diagnostic tool in determining recent past drug use as well as examining long-term drug history through segmental analysis (i.e. identification and quantification of drugs along the length of the hair shaft from scalp hair). The usefulness and the importance of hair analysis depends on the ability to identify and quantify drugs and metabolites in hair that arise from ingestion but not from passive exposure or exogenous application of drugs.
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ingestion.1
Hair has been used as an alternative and complementary matrix in a number of cases; such as a case of accidental cocaine poisoning2 and a case of drug addiction.3 A 25-year-old man unknowingly consumed an entire bottle of an imported Columbian soft drink (Pony Malta) that contained smuggled cocaine in it. The man was hospitalized for acute cocaine intoxication but died 24 days later. The blood sample on his hospital admission contained 2.3 mg/L of cocaine and 4.5 mg/L of benzoylecgonine, whereas the segmental analysis of hair from the autopsy sample revealed a peak cocaine concentration in the segment corresponding to the time he ingested the tainted beverages.2 In another case, the addiction history of a dead woman was evaluated after exhumation and sectional hair testing. The post-mortem blood and urine analysis confirmed recent opiate and cannabis use and indicated that her death was associated with heroin abuse. Several months later, the womans family asked for exhumation and re-examination of the body, insisting that the cause of death was homicide. The drug profile in the hair shaft was investigated by segmental analysis which revealed that the total morphine concentration in the hair sections corresponding to the three month period before death were significantly lower than those of the four to ten month period before death. Therefore, the cause of death could have been the decrease of tolerance to heroin caused by abstinence and relapse in use.3 Other evidence of drug-hair analysis cited in the literature include a fatal case involving polydrug use (heroin, cocaine, cannabis, chloroform, thiopental, and ketamine); evidence of gestational heroin exposure by comparative analysis of fetal and maternal body fluids, tissues and hair; and intrauterine drug exposure during second trimester of pregnancy in a heroin-associated death. Recently emerged drugs such as piperazines, cathinones, and synthetic cannabinoids have also been detected in hair. Simultaneous detection methods have been developed to analyze different classes of drugs (opiates, amphetamines, cocaine and metabolites, diazepam and metabolite) from a single extraction method which makes it suitable for general toxicology screening.4 There are some issues that need to be considered while using hair analysis as an alternative and complementary matrix for forensic drug testing. The external presence of drugs in hair via passive exposure should be taken into account during the sample preparation and evaluation of results. Similarly cosmetic treatments and the presence of endogenous compounds such as GHB and cortisol can affect the concentration of drug detected in hair and hence care should be taken while interpreting such results. In this regard, SoHT has published internationally accepted guidelines.1This provides step-by-step guidance for hair analysis, including sample collection, storage, preparation, pre-treatment, analysis, and the use of cut-offs in order to enable identification of chronic drug use. Cut-offs for chronic alcohol use have been discussed in the Societys consensus documents as hair is also analyzed to detect alcohol. SoHT also runs a proficiency testing program annually and there are two other such schemes available in Europe: a) HAIRVEQ established by the Istituto Superiore di Sanit of Rome in Italy, in cooperation with Institut Municipal dInvestigaci Mdica of Barcelona in Spain; and b) GTFCh set up by the German Society of Toxicological and Forensic Chemistry. SoHT recommends that segmental analysis should be carried out when the analyte is endogenously present such as GHB and cortisol. This is because these compounds should be detected at an elevated level at the time corresponding with exposure. Conclusion Hair samples are useful as a matrix for drug testing because drugs can be detected for longer periods than in blood or urine or other biological samples. The use of hair analysis as an adjunct to traditional samples may help document drug use history and is especially useful in situations when blood and urine specimens have not been collected on time. The drug screening of hair as an alternative and complementary matrix provides important information in various drug-related investigations, including DFSA, patient compliance, and gestational exposure. It is recommended to collect hair samples in all cases for later analysis if warranted by additional history or autopsy findings. Method accreditation is challenging due to limited availability of certified reference materials to be used as external quality controls and hence participation of hair testing laboratories in proficiency testing programs is highly recommended. References 1. G.A.A. Cooper, R. Kronstrand, and P. Kintz, Society of Hair Testing guidelines for drug testing in hair. Forensic Science International, 218 (2012), 20-24. 2. R. Martz, B. Donnelly, D. Fetterolf, L. Lasswell , G.W. Hime, W.L. Hearn, The use of hair analysis to document a cocaine overdose following a sustained survival period before death. Journal of Analytical Toxicology, 15 (1991), 279-281. 3. A.M. Tsatasakis, M.N. Tzatzarakis, D. Psaroulis, C. Levkidis, and M. Michalodimitrakis, Evaluation of the addiction history of a dead woman after exhumation and sectional hair testing. American
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4. R. Cordero, and S. Paterson, Simultaneous quantification of opiates, amphetamines, cocaine and metabolites and diazepam and metabolite in a single hair sample using GC-MS. Journal of Chromatography B, 850 (2006), 423-431. Lata Gautam holds a B.Sc. (Hons.) and M.Sc. from Tribhuvan university in Nepal and a Ph.D. in Forensic Science from Anglia Rusk in University in the U.K. She is currently a Senior Lecturer in Forensic Science at Anglia Rusk in University. Her research interests include Forensic Toxicology and the analysis of drugs from biological matrices. Mik e Cole holds a B.A. (Hons.) in Natural Sciences from the University of Cambridge, U.K. and a Ph.D. in Natural Product Chemistry from the university of London. He is currently Professor of Forensic Science and Faculty Director of Research, Knowledge Transfer, and Scholarship in the Faculty of Science and Technology at Anglia Rusk in University. His research interests include development of analytical methods for street drugs and methods for drug comparison.
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