A series of forensic toxicology and drug seizure cases involving illicit fentanyl alone and in combination with heroin, cocaine or heroin and cocaine.

The Montgomery County Coroner's Office Toxicology Section and the Miami Valley Regional Crime Lab (MVRCL) Drug Chemistry Section have been receiving case work in drug seizures, death cases and human performance cases involving products marketed as heroin or as illicit fentanyl. Upon analysis by the Drug Chemistry Section, these products were found to contain various drug(s) including illicit fentanyl only, illicit fentanyl and heroin, illicit fentanyl and cocaine and illicit fentanyl, heroin and cocaine. Both the Chemistry and Toxicology Sections began seeing these combinations starting in late October 2013.

Analysis of synthetic cathinones commonly found in bath salts in human performance and postmortem toxicology: method development, drug distribution and interpretation of results.

To date, the Toxicology Section of the Montgomery County Coroner's Office/Miami Valley Regional Crime Laboratory has identified six synthetic cathinones, commonly found in bath salt products, in 43 cases. Thirty-two cases will be reviewed here, including all of the postmortem cases, all of the human performance cases that had blood specimens submitted, and one urine-only human performance case. The following compounds have been confirmed: 3,4-methylenedioxypyrovalerone (MDPV), 3,4-methylenedioxymethcathinone (methylone), pyrovalerone, pentylone, alpha-pyrrolidinopentiophenone (alpha-PVP) and methedrone.

Gamma butyrolactone (GBL) and gamma valerolactone (GVL): similarities and differences in their effects on the acoustic startle reflex and the conditioned enhancement of startle in the rat.

Gamma butyrolactone (GBL) is metabolized to gamma hydroxybutyrate (GHB) in the body. GHB is a DEA Schedule 1 compound; GBL is a DEA List 1 chemical. Gamma valerolactone (GVL) is the 4-methyl analog of GBL; GVL is metabolized to 4-methyl-GHB; GVL is NOT metabolized to GBL or GHB.

A gas chromatography-thermal conductivity detection method for helium detection in postmortem blood and tissue specimens.

In cases of death by inert gas asphyxiation, it can be difficult to obtain toxicological evidence supporting assignment of a cause of death. Because of its low mass and high diffusivity, and its common use as a carrier gas, helium presents a particular challenge in this respect. We describe a rapid and simple gas chromatography-thermal conductivity detection method to qualitatively screen a variety of postmortem biological specimens for the presence of helium.

Ethanol production in a postmortem urine sample.

Significant ethanol production in a urine sample is not a common phenomenon that occurs in postmortem volatile anaylsis. Here, a 66-year-old female decedent with a history of renal failure and diabetes originally presented at the hospital as "acting funny". After expiring at the hospital, the toxicology section received both hospital and postmortem samples for analysis.

A fatality from an oral ingestion of methamphetamine.

The case presented is of a 49-year-old white male decedent who admitted to oral ingestion of methamphetamine. He believed he was being followed by the police while walking his daughter to school in the morning and swallowed the "8-ball of meth," which is known to be one-eighth of an ounce or the equivalent of about 3 g. The following autopsy specimens were analyzed for the presence of methamphetamine and amphetamine by gas chromatography-mass spectrometry: femoral blood, urine, bile, vitreous fluid, brain, liver, and gastric contents.

The analysis of delta9-tetrahydrocannabinol and metabolite in whole blood and 11-nor-delta9-tetrahydrocannabinol-9-carboxylic acid in urine using disposable pipette extraction with confirmation and quantification by gas chromatography-mass spectrometry.

Essential to forensic laboratories is the desire to find a more sensitive, rapid method of analyzing Delta9-tetrahydrocannabinol (THC) and metabolite in biological specimens. Disposable pipette extraction (DPX) is a valuable method in extracting THC and 11-nor-Delta9-tetrahydrocannabinol-9-carboxylic acid (THCc) in blood and THCc in urine. Less waste and solvent usage; smaller specimen volume; clean chromatograms; and utilization of lowcost equipment and consumables were achieved using this method.

Vitreous fluid quantification of opiates, cocaine, and benzoylecgonine: comparison of calibration curves in both blood and vitreous matrices with corresponding concentrations in blood.

Vitreous fluid specimens are often used in the Montgomery County Coroner's Office as a second matrix confirmation for both cocaine and opiate analyses. In this manuscript, calibration curves constructed for both vitreous and blood were used to quantify vitreous specimens to evaluate if any matrix effects occur when measuring vitreous specimens using a calibration curve in blood. Cases that screened positive by ELISA for cocaine metabolite and opiates were confirmed by solid-phase extraction.

Over-the-counter cold medications-postmortem findings in infants and the relationship to cause of death.

The Montgomery County Coroner's Office has encountered a series of 10 infant deaths over an 8-month period in infants under 12 months old with toxicology findings that include a variety of drugs commonly found in over-the-counter (OTC) cold medications. The drugs detected were ephedrine, pseudoephedrine, dextromethorphan, diphenhydramine, chlorpheniramine, brompheniramine, ethanol, carbinoxamine, levorphanol, acetaminophen, and the anti-emetic metoclopramide. Toxicology findings were confirmed in 2 different matrices in 9 of the 10 cases and by 2 different analytical methods.

Analysis of GHB and 4-methyl-GHB in postmortem matrices after long-term storage.

Postmortem heart blood, peripheral blood, vitreous humor, urine, and bile specimens from 26 autopsy cases were analyzed for the presence of gamma-hydroxybutyric acid (GHB) and gamma-methyl gamma-hydroxybutyric acid (4-Me-GHB) after long-term freezer storage. Cases were selected for which exogenous GHB, gamma-butyrolactone (GBL), gamma valerolactone (GVL), or 1,4-butanediol use was not suspected. One documented positive GHB case subjected to the same storage conditions was also evaluated for comparison.