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The majority of articles concerning drugs-of-abuse in human brain specimens were published in the 1980s. They focused primarily on opiates, cocaine, and cocaine metabolites - specifically, the interpretation of data when determining time intervals between administration of the drug and death and in determining the role of these drugs in the cause of death itself. This chapter presents an overview of those publications, as well as developments in techniques for sample preparation, automation, and detection, which, when combined with the routine use of stable isotope internal standards, promise more comparable results and could lay the foundation for a data collection of reliable reference values. Moreover, recently developed immunohistochemical techniques could pave the way for the systematic investigation of the function of drugs-of-abuse in specific substructures of the brain. [ABSTRACT FROM AUTHOR]

The liver is the largest organ in the human body and has been used extensively as an important specimen in postmortem toxicology analysis. This chapter describes the advantages and disadvantages of using liver as a specimen for the detection and measurement of drugs-of-abuse in postmortem cases. The liver comprises relatively soft tissue amenable to the preparation of homogenates but contains high concentrations of lipids that may interfere in some analytical procedures. As a specimen, liver has the advantage that it is relatively unaffected by postmortem redistribution compared with blood, but drug concentrations in the lobe proximal to the stomach may be affected by postmortem diffusion in cases of oral overdose. The biggest impediment to the routine use of liver for the interpretation of positive drug findings is the lack of a comprehensive database of liver concentrations. The data contained here may assist those wishing to interpret liver concentrations of drugs-of-abuse. As for all drugs and specimens, the process of interpretation should include consideration of all aspects of the death investigation, including, as necessary, analysis of multiple specimens. [ABSTRACT FROM AUTHOR]

Bone and bone marrow are specimens recently investigated as a matrix for drug testing. Following extraction by soaking bone in organic solvent, routine drug assays may be utilized to measure compounds. Antidepressants, benzodiazepines, and illicit drugs such as cocaine have been reported in bone. [ABSTRACT FROM AUTHOR]

Vitreous humor is a fluid contained in the eye that is largely composed of water. Its value for the postmortem analysis of ethanol has been well established. However, studies of drug disposition into vitreous humor are limited. This chapter reviews pertinent studies that have examined drug deposition into vitreous humor. The specific drugs/drug classes that are discussed include amphetamines, cocaine, THC, and opioids. Some of the advantages of vitreous humor as a matrix for drug analysis include the increased stability of certain drugs in this matrix and its amenability to analysis with little or no pretreatment. Disadvantages of vitreous humor analysis include a limited specimen volume and the limited interpretative value of analytical results. [ABSTRACT FROM AUTHOR]

Drug testing is commonly used as a deterrent to drug use in both the workplace and criminal justice systems. While the majority of these tests are conducted in urine, an increasing number of tests are being conducted using alternative biological specimens such as hair, oral fluid, blood, and sweat. The purpose of this chapter is to review the use of sweat as a biological matrix for the testing of drugs subject to abuse. This chapter will provide an overview of the structure of the skin, describe the composition of sweat, how the body produces sweat, examine the approaches used to collect sweat for analysis, provide an overview of the history of the detection of drugs in sweat, describe analytical approaches for the testing of sweat for the presence of drugs including procedures, and finally address the interpretation of drug test results in sweat. [ABSTRACT FROM AUTHOR]

Historically, saliva or oral fluid has been tested for monitoring therapeutic drugs. Drugs-of-abuse, including cannabinoids, opioids, amphetamines, and cocaine, have been detected in this matrix. Multiple collection procedures and devices are available. The route of administration, collection procedures, and saliva : plasma ratios affect the amount of drug deposited. However, current analytical techniques may be utilized for testing provided the relevant compound is targeted. The window of detection is comparable to blood and is therefore conducive to detecting recent drug use. [ABSTRACT FROM AUTHOR]

This chapter describes the composition of amniotic fluid and breast milk and the mechanisms known to effect drug transfer to these matrices. Drugs-of-abuse detected in these specimens and discussed in this chapter include cocaine and metabolites, phencyclidine (PCP), benzodiazepines, barbiturates, opioids, amphetamines and cannabinoids. [ABSTRACT FROM AUTHOR]

The utility of nails in forensic toxicology for the analysis of drugs-of-abuse is examined. This chapter reviews the basic structure of the nail, mechanisms of drug incorporation, drugs-of-abuse that have been detected in nails, analytical methodologies, interpretation of results, advantages and disadvantages, and a chronological review of the literature. Drugs-of-abuse that are discussed within this chapter include amphetamine, methamphetamine, MDMA/MDA, cocaine and its metabolites, morphine, codeine, 6-acetylmorphine, hydrocodone, hydromorphone, oxycodone, methadone, cannabinoids, and phencyclidine. [ABSTRACT FROM AUTHOR]

Meconium is the first fecal material passed by the newborn. It begins to form between 12 and 16 weeks of gestation and therefore, may provide a history of in utero drug exposure during the second and third trimesters. Although meconium is easy to collect, small sample sizes, lack of homogeneity, different metabolic profiles, and the requirement for low limits of detection present analytical challenges for drug testing. Immunoassay screening assays and mass spectrometric-based confirmation procedures have been described for the common drugs-of-abuse. [ABSTRACT FROM AUTHOR]

Given the limitations of self-reports on drug use, testing for drugs-of-abuse is important for most clinical and forensic toxicological situations, both for assessing the reality of the intoxication and for evaluation of the level of drug impairment. It is generally accepted that chemical testing of biological fluids is the most objective means of diagnosis of drug use. The presence of a drug analyte in a biological specimen can be used to document exposure. The standard in drug testing is the immunoassay screen, followed by the gas chromatographic-mass spectrometric confirmation conducted on a urine sample. In recent years, remarkable advances in sensitive analytical techniques have enabled the analysis of drugs in unconventional biological specimens such as hair. The advantages of this sample over traditional media, like urine and blood, are obvious: collection is noninvasive, relatively easy to perform, and in forensic situations, it may be achieved under close supervision of law enforcement officers to prevent adulteration or substitution. The window of drug detection is dramatically extended to weeks, months, or even years when testing hair. It appears that the value of analysis of alternative specimens for the identification of drug users is steadily gaining recognition. This can be seen from its growing use in pre-employment screening, in the forensic sciences, in clinical applications, and for doping control. Hair analysis may be a useful adjunct to conventional drug testing in urine. Methods for evading urinalysis do not affect hair analysis. The aim of this chapter is to document toxicological applications of hair analysis in drug detection. [ABSTRACT FROM AUTHOR]