General autopsy considerations

External examination in cases of oral drug abuse (i.e., pills or liquid medications) is generally not rewarding unless actual medication or medication residue is observed in the mouth or on the hands. However, as noted earlier, multiple parallel scars on the wrists or neck suggest prior suicide attempts and a subsequent suicidal drug overdose. Bite marks (contusions and lacerations) of the tongue and lower lip should be specifically sought because these frequently accompany terminal convulsions...

Ch2chnhch3

Decomposition Amphetamine

Figure 1.4.9.3 Clandestine laboratory synthesis of methamphetamine. vogue and was known then and is still referred to as Ecstasy. The synthesis of 3,4-methylenedioxymethamphetamine (MDMA) follows the same synthetic protocols as the less complicated phenethylamines. The clandestine laboratory operator or research chemist selectively adds one N-methy group, an N,N-dimethyl group, an N-ethyl group, an N-propyl, an N-isopropyl group, and so on. In 1985 the N-hydroxy MDA derivative was reported.15...

Alterations associated with intravenous drug abuse

Intravenous drug abusers may crush oral medications and make them soluble for intravenous injection. Methadone24 and propoxyphene25 are examples of oral drugs that are abused in this fashion. The filler material in the pills contains insoluble particles that cause thrombosis, granulomatous inflammation, and fibrosis in the lungs. The granulomas have numerous multinucleated giant cells and birefrigent foreign material (Figure 2.3.2). In addition to their morphology, the foreign particles can be...

Examination of the Myocardium in Ischemic Heart Disease

Papillary Muscle Infarct

In the presence or absence of acute or healed myocardial infarction, the myocardium is best examined by slicing the ventricles in a manner similar to a loaf of bread. To evaluate the specimen, a series of short-axis cuts are made through the ventricles from apex to base (Figure 2.2.1.5A). This method is best accomplished using a long, sharp knife on the intact fixed specimen following examination of the coronary arteries. With the anterior aspect of the heart downward (against the cutting...

Cocaine

Cocaine Metabolic Metabolism

Cocaine is a naturally occurring alkaloid obtained from the plant Erythroxylon coca L. This plant grows in the Andes region of South America, ideally at elevations between 1,500 to 5,000 ft.1 A second closely related species has been identified , Erythroxylon novogranatense H., and each species has one variety known as E. coca var. ipadu Plowman and E. coca novogranatense var. truxilllense, respectively. Cocaine may also be chemically synthesized with cold aqueous succinaldehyde and cold...

Pathology encountered in crack smokers

Bailey et al.1 examined the lungs of dead cocaine abusers and found the most common pulmonary findings were pulmonary congestion (88 ), edema (77 ), and acute chronic alveolar hemorrhage (71 ). These findings have been also reported by Murray et al.2-3 found hemosiderin-laden macrophages in 35 (7 20) of the victims of cocaine intoxication and opined that occult alveolar hemorrhage occurs more frequently in cocaine users than is clinically recognized. They also noted pulmonary artery medial...

Marijuana

The Metabolite Thc

The term marijuana refers to all parts of the plant Cannabis sativa L., whether growing or not the seeds resin extracted from any part of such plant and every compound, salt, derivative or mixture, but does not include the mature stalks, fiber produced from the stalks, or oil or cake prepared from the seeds.1 Cannabis sativa L. is an annual plant that grows in all parts of the world to a height of 16 to 18 ft. Commercially, it is cultivated for hemp production, with the bulk of the plant...

Myocardial Disease in Stimulant Abusers

Clinical reports of dilated cardiomyopathy, where neither biopsies nor arteriograms are obtained, are impossible to interpret, and the real diagnosis must remain in question.35-39 But even in the absence of florid heart failure, certain types of morphologic alterations are frequently seen in the hearts of individuals dying from stimulant abuse. Most of the observed changes appear to be catecholamine mediated40-42. Chronic catecholamine toxicity is a well-recognized entity in animals and humans....

Identifying Adulterants and Diluents

The terms adulterants and diluents are sometimes used in the context of illicitly distributed controlled substances. Adulterants are chemicals added to illicit drugs which, in and of themselves, can affect some sort of a physiological response. This response can range from very mild to quite severe. Diluents are chemicals added to controlled substances which are used more as fillers than to elicit a physiological response. They can be added to affect the color and composition for the sake of...

Analyzing Drugs In The Forensic Science Laboratory

No other topic related to the identification of controlled substances causes as much controversy as testing specificity. Forensic science laboratories conduct two different categories of tests. Tests in the first category are called screening tests. They include a series of tests used to make a preliminary determination of whether a particular drug or class of drugs is present. It must be emphasized that screening tests are not used to positively identify any drug. At best, screening tests can...

Identifying and Quantitating Controlled Substances

Whenever a controlled substance is identified, the possibility exists that an individual could be imprisoned or suffer some other legal consequence as a result. There is, therefore, an absolute, uncompromised requirement for certainty in the identification of controlled substances. Prior to 1960, the results of microscopic crystal tests, color screening tests, and TLC were considered definitive. From the 1960s through the mid-1970s, ultraviolet spectrophotometry and GC gained acceptance. It is...