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Forensic toxicology of drug dependence
Raekallio,
J. (Turku,
TIMING
WOUNDS.
OF
Finland) AN
INTRODUCTORY
REVIEW
The author reviews the literature dealing with the application of histological, histochemical, scanning electron microscopical (SEM), and biochemical methods for the estimation of the age of wounds in the skin and other organs. According to the data presented, it is possible to distinguish biochemically between ante-mortem and post-mortem skin wounds after a survival time of a few seconds or minutes. By using SEM, the time is as little as 5 seconds. The methods of enzyme histochemistry act as a guide to the estimation of the approximate age of the injuries inflicted 1 - 16 h before death. The timing of wounds is more reliable when several independent methods are used concurrently. In addition to histology, biochemical and histochemical methods are applicable even in forensic pra&ice. Rajs, J. and S. Jakobsson ON
THE
HBFP-STAINING
(Stockholm,
Sweden)
TECHNIQUE
Since Lie and co-workers in 1971 published the HBFP-staining technique as a simple and reliable method for the diagnosis of early myocardial infarction, this method has been used in many publications dealing with myocardial lesions of ischaemic type. Our experience in using the HBFP-staining method on human autopsy material, as well as on experimentally induced infarction in animals, suggests caution in the interpretation of the results obtained. A positive staining may occur, even in non-infarcted areas, after agonal mechanical heart injuries, as a result of autolysis and the procedure of tissue fixation. Furthermore in apparently infarcted areas an expected positive result may not occur. A positive HBFP-staining does not always seem to demonstrate a vital phenomenon. Robinson, FORENSIC
A. E. (London, TOXICOLOGY
U.K.) OF
DRUG
DEPENDENCE
The purpose of this paper is to present a critical reappraisal of toxicological data relating to deaths of persons using heroin (or morphine) or methadone, alone, in combination, or with other drugs. Even when the analytical methods are sensitive, specific, and permit good recoveries, what do the numbers mean? Can the toxicologist provide evidence to allow the distinction of drug overdosage from an adverse reaction? What data may be adduced in relation to tolerance? Are the impurities/diluents/additives in locally available illicit drugs relevant to the mode of death of those using the drugs and is their presence reflected by the distribution of the drugs at autopsy? Does the ‘mean lethal blood level’ have any meaning in relation to heroin (morphine) or methadone linked deaths? These points will be discussed and illustrated by reference to published data and specific cases.
J. (Turku,
TIMING
WOUNDS.
OF
Finland) AN
INTRODUCTORY
REVIEW
The author reviews the literature dealing with the application of histological, histochemical, scanning electron microscopical (SEM), and biochemical methods for the estimation of the age of wounds in the skin and other organs. According to the data presented, it is possible to distinguish biochemically between ante-mortem and post-mortem skin wounds after a survival time of a few seconds or minutes. By using SEM, the time is as little as 5 seconds. The methods of enzyme histochemistry act as a guide to the estimation of the approximate age of the injuries inflicted 1 - 16 h before death. The timing of wounds is more reliable when several independent methods are used concurrently. In addition to histology, biochemical and histochemical methods are applicable even in forensic pra&ice. Rajs, J. and S. Jakobsson ON
THE
HBFP-STAINING
(Stockholm,
Sweden)
TECHNIQUE
Since Lie and co-workers in 1971 published the HBFP-staining technique as a simple and reliable method for the diagnosis of early myocardial infarction, this method has been used in many publications dealing with myocardial lesions of ischaemic type. Our experience in using the HBFP-staining method on human autopsy material, as well as on experimentally induced infarction in animals, suggests caution in the interpretation of the results obtained. A positive staining may occur, even in non-infarcted areas, after agonal mechanical heart injuries, as a result of autolysis and the procedure of tissue fixation. Furthermore in apparently infarcted areas an expected positive result may not occur. A positive HBFP-staining does not always seem to demonstrate a vital phenomenon. Robinson, FORENSIC
A. E. (London, TOXICOLOGY
U.K.) OF
DRUG
DEPENDENCE
The purpose of this paper is to present a critical reappraisal of toxicological data relating to deaths of persons using heroin (or morphine) or methadone, alone, in combination, or with other drugs. Even when the analytical methods are sensitive, specific, and permit good recoveries, what do the numbers mean? Can the toxicologist provide evidence to allow the distinction of drug overdosage from an adverse reaction? What data may be adduced in relation to tolerance? Are the impurities/diluents/additives in locally available illicit drugs relevant to the mode of death of those using the drugs and is their presence reflected by the distribution of the drugs at autopsy? Does the ‘mean lethal blood level’ have any meaning in relation to heroin (morphine) or methadone linked deaths? These points will be discussed and illustrated by reference to published data and specific cases.