What is Toxicology?

Drugs and Alcohol:

Toxicology

Toxicological examinations involve the

identification and often quantization of
drugs & toxic materials in the human body

The role of the forensic toxicologist is
limited to matters pertaining to violations of
criminal law

Introduction
Toxicologists are charged with the responsibility for
detecting and identifying the presence of drugs and
poisons in body fluids, tissues, and organs.

Toxicologists not only work in crime laboratories and
medical examiners offices, but may also reach into
hospital laboratories and health facilities to identify a
drug overdose or monitor the intake of drugs.

A major branch of forensic toxicology deals with the
measurement of alcohol in the body for matters that
pertain to violations of criminal law.

Chemical Properties of
Ethanol

A clear volatile liquid

Burns easily


oxidizes easily

Slight, characteristic odor

Is very soluble in water


miscible in all proportions

determination of the presence of alcohol in

the body
identification of substances causing unnatural
death

Properties of Alcohol

Alcohol is a general term for a family of

organic compounds


commonly encountered members include

methanol, ethanol, isopropanol

The term alcohol will be taken to mean

ethanol (ethyl alcohol, CH3CH2OH)

Physiological Properties of
Ethanol

A central nervous system (CNS)

depressant

CNS is the bodily system which is most

severely affected by alcohol

The degree to which the CNS function is

impaired is directly proportional to the

concentration of alcohol in the blood

What Does the Body Do With

Alcohol?

Alcohol Absorption

When an alcoholic beverage is

Alcohol is absorbed from all parts of the

swallowed, it is diluted by stomach juices

& quickly distributed throughout the body

Alcohol does not require digestion before
its absorption into the bloodstream


some diffuses into bloodstream directly

through the stomach wall
remainder passes into the small intestine
 rapidly

absorbed & circulated

gastrointestinal tract largely by simple

diffusion into the blood


small intestine is the most efficient region

for absorption because of its large surface
area

The rate of absorption varies according

to the particular beverage & the state of

the consumers stomach

Alcohol absorption

Alcohol Absorption

Fasting individual

Non-fasting individuals

20-25% of a dose of alcohol is absorbed

from the stomach
75-80% is absorbed from the small
intestine
peak blood alcohol concentrations occur in
0.5-2.0 hrs

presence of food in stomach (especially

fatty foods) delays absorption
 peak

alcohol concentrations 1.0-6.0 hrs

Alcohol ingested with carbonated

beverages


ordinarily absorbed more rapidly than

straight alcohol

Alcohol Distribution

Alcohol Distribution

Alcohol has a high affinity for water

Absorbed alcohol is greatly diluted by

Is diffused in the body in proportion to

the water content of the various tissues

& organs



greater concentration in blood & brain

lesser concentration in fat & muscle

the aqueous body fluids



1 oz. (29.57 mL) of 50% (100 proof)

whiskey will be diluted in a man of average
build, to a concentration ~2 parts per
10,000 in the blood (0.02%)

Blood Alcohol concentration

Elimination

BAC is the amount of alcohol in the

The liver eliminates ~95% of the alcohol

through metabolism

bloodstream measured in percentages



BAC = 0.10%
 means

a person has 1 part alcohol per 1,000

parts of blood in the body

oxidation via acetaldehyde & acetic acid to

carbon dioxide & water

Remainder of eliminated through

excretion in breath, urine, sweat, feces,

milk & saliva

Rule of Thumb


Blood Alcohol Concentrations

0.5 oz (15 mL) alcohol eliminated per hr

Elimination

A set of probable
average curves of
BAC in an averagesize man after rapid
absorption of various
amounts of alcohol

Shows rate of BAC
decline over time as
a result of
metabolism &
excretion

Absorbed alcohol is passed through the

liver by circulating blood

ADH (alcohol dehydrogenase) converts

the alcohol to acetaldehyde

 acetaldehyde is a highly toxic substance

Aldehyde dehydrogenase converts

acetaldehyde to acetate ion

Acetate enters blood stream & is

ultimately oxidized to CO2

Elimination

Both enzymatic reactions require a co-

enzyme, NAD, which accepts a

hydrogen from the molecule

The temporary depletion of NAD by the
first step limits the rate at which alcohol
can be metabolized

Curve a


drinking 2 oz
alcohol each hr for 4
hours


BAC increase is
cumulative
because alcohol
is consumed
faster than it can
be metabolized

Curve b


drinking 8 oz all at
once

BACs Affect Behavior

Alcohol in the bloodstream continually circulates to the brain

BAC

Affect

0.04%

Feelings of contentment, happiness,

relaxation

0.06%

Judgement somewhat impaired

Some loss of coordination
Less able to make rational decisions
Muscle coordination & driving
impaired

0.08%
0.30%

Some Alcohol Statistics

Loss of consciousness may occur

Breathing may stop (death may
result)

Alcohol & Driving

Relative Fatality Risk(drivers
in a single vehicle crash)

~half of traffic injuries involve alcohol

~1/3 of fatally injured passengers &

pedestrians have elevated blood alcohol

levels

~half of homicides involve alcohol

1/2 to 1/3 of suicides involve alcohol

CDC estimates ~30,000 unintentional
injury deaths are directly attributable to
alcohol

Alcohol and Law

Alcohol and Law

The American Medical Association and the National
Safety Council have been able to exert considerable
influence in convincing the states to establish uniform
and reasonable blood-alcohol standards.

Between 1939 and 1964 a person having a bloodalcohol level in excess of 0.15 percent w/v was to be
considered under the influence, which was lowered to
0.10 percent by 1965.

In 1972 the impairment level was recommended to
be lowered again to 0.08 percent w/v.

Starting in 2003, states that have not adopted the 0.08

percent level will lose part of their federal funds for
highway construction.

To prevent a persons refusal to take a test for alcohol
consumption, the National Highway Traffic Safety
Administration recommended an implied consent law.

Adopted by all states by 1973, this law states that the
operation of a motor vehicle on a public highway
automatically carries with it the stipulation that a driver
will submit for a test for alcohol intoxication if requested
or be subject to loss of the license.

Alcohol in Blood vs Breath

The ratio of alcohol in blood to alcohol in

alveoli air is 2100 to 1

1 mL of blood will contain about the same

amount of alcohol as 2100 mL of breath

During the period of absorption, the alcohol

concentration is higher in arterial blood than

venous blood
breath test reflects alcohol conc. in the pulmonary
artery (reflects what reaches the brain)

Alcohol and Circulatory

System

Respiratory System

Humans have a closed circulatory system consisting of a heart,

arteries, veins, and capillaries.

Alcohol is absorbed from the stomach and small intestines into the

blood stream.

Alcohol is carried to the liver where the process of its destruction

starts.

Blood, carrying alcohol, moves to the heart and is pumped to the

lungs.

In the lungs, carbon dioxide and alcohol leave the blood and

oxygen enters the blood in the air sacs known as alveoli.

Then the carbon dioxide and alcohol are exhaled during breathing.

Volatile chemicals dissolved in the blood will be

brought to equilibrium with the air in the lungs


The Breathalyzer

Measures the alcohol content of alveolar

breath

Subject blows into a mouthpiece until
52.5 mL of alveolar breath has been
collected


measures alcohol concentration of 1/40 mL

of blood

The alcohol in the blood is reacted with

chromic acid

fixed ratio between compound in breath & blood

Breathalyzer
2 K2Cr2O7 + 3 C2H5OH + 8 H2SO4

2 Cr2(SO4)3 + 3 CH3COOH + 11 H2O

Cr (III)

Cr (VI)
absorbs at 420 nm

Beers Law

the concentration of Cr (VI) is directly proportional to the

amount of 420 nm light light absorbed by the sample

Measures the concentration of the unknown solution to
the concentration of a standard sample


Breath Tests for Alcohol

Intoxilyzer





Breath Tests for Alcohol

Alcosensor


Measures the infrared radiation absorption in a specific

wavelength to confirm the presence of organic
chemicals
Detects only ethyl alcohol
Requires suspect to blow into a mouthpiece to give a
sample

Field Testing

Field Testing
Law enforcement officers typically use field sobriety tests
to estimate a motorists degree of physical impairment by
alcohol and whether or not an evidential test for alcohol is
justified.

The horizontal gaze test, walk and turn, and the one-leg
stand are all considered reliable and effective
psychophysical tests.

A portable, handheld, roadside breath tester may be used
to determine a preliminary breath-alcohol content.

Field sobriety testing: assesses a drivers degree of

physical impairment












widely used approach for determining alcohol levels in

blood.

Blood must always be drawn under medically accepted
conditions by a qualified individual.

It is important that a nonalcoholic disinfectant be applied
before the suspects skin is penetrated with a sterile
needle or lancet.

Once blood is removed from an individual, its
preservation is best ensured when it is sealed in an
airtight container after an anticoagulant and a
preservative have been added and stored in a
refrigerator.

Interview with officer

Preliminary examination
Eye examination
Divided attention psychophysical tests
Vital signs exam
Dark room exam
Muscle rigidity exam
Examination for injection site
Suspects statements
Opinions of evaluator
Toxicology exam

Role of the Toxicologist

Gas Chromatography Testing

Gas chromatography offers the toxicologist the most

The alcohol fuel cell consists of a porous, chemically

inert layer that is coated on both sides with a thin
platinum layer.
Any ethyl alcohol present in the breath samples is
converted to acetic acid.
A microprocessor measures the electrical current
and converts the measured electrical current into a
BAC.

Beyond the analysis of alcohol, the toxicologist is

confronted with a maze of drugs and poisons.

The toxicologist is originally presented with body
fluids and/or organs and is normally requested to
examine them for the presence of drugs and poisons.

Without supportive evidence, such as the victims
symptoms, a postmortem pathological examination,
or an examination of the victims personal effects, the
toxicologist is forced to use general screening
procedures with the hope of narrowing thousands of
possibilities to one.

Role of the Toxicologist

The Analytical Scheme

The forensic toxicologist must devise an analytical
scheme that will successfully detect, isolate, and
specifically identify toxic drug substances.

Once the drug has been extracted from appropriate
biological fluids, tissues, and organs, the forensic
toxicologist can proceed to identify the drug
substance present.

Drug extraction is generally based on a large number
of drugs being either acidic or basic.

The strategy used for identifying abused drugs entails
a two-step approach: screening and confirmation.

In addition, the toxicologist is not dealing with drugs

at the concentration levels found in powders and pills,
having been dissipated and distributed throughout
the body.

Furthermore, the body is an active chemistry
laboratory as few substances enter and completely
leave the body in the same chemical state.

Last, when and if the toxicologist has surmounted all
of these obstacles, he or she must be prepared to
assess the toxicity of the drug or poison.

The Screening Step

The Confirmation Step

Gas chromatography/mass spectrometry is generally
accepted as the confirmation test of choice.

The GC separates the sample into its components,
while the MS represents a unique fingerprint pattern
that can be used for identification.

Once the drug is extracted and identified, the
toxicologist may be required to provide an opinion on
the drugs effect on an individuals natural
performance or physical state.

A screening test is normally employed to

provide the analyst with quick insight into the
likelihood that a specimen contains a drug
substance.

Positive results arising from a screening test
are considered to be tentative at best and must
be verified with a confirmation test.

The most widely used screening tests are thinlayer chromatography, gas chromatography,
and immunoassay.

Postmortem Toxicology

The DRE

The Drug Recognition Expert program incorporates

standardized methods for examining automobile drivers who are

suspected of being under the influence of drugs.

To ensure that each subject has been tested in a routine
fashion, each DRE must complete a standard Drug Influence
Evaluation form.

The DRE program usually cannot determine which specific drug
was ingested.

Hence, it is the production of reliable data from both the DRE
and the forensic toxicologist that is required to prove drug
intoxication.

Postmortem analysis
 Investigates the presence of drugs, gases, metals, and
other toxic chemicals in human fluids and organs
 Determines their role, if any, in the death

Begins with a case history of the deceased

Includes age, sex, weight, medical history, medication
before death, autopsy findings, drugs available to
decedent, and interval between onset of symptoms and
death

Includes analyses for poisons as diverse as prescription
drugs, drugs of abuse, chemical products, and gases

Postmortem Toxicology

Collection of postmortem specimens


All body fluids and organs in which chemicals might

concentrate are collected during the autopsy.
Specimens should be collected before the body is
embalmed.
In cases of decayed bodies, analysis may be done
on bone marrow, fluid in the eye, or hair.
Maggots feeding on the corpse have been tested
for drugs and used as evidence.

Postmortem Toxicology

Analysis of toxicology specimens


Postmortem Toxicology

Postmortem Toxicology

Analysis of toxicology specimens


A positive immunoassay test leads to a confirmation

test (usually gas chromatographymass
spectrometry).
Each compound gives a characteristic fragment
spectrum.
A computer compares the samples spectrum to a
reference library.
The toxicologist tests for an inorganic substance if the
case study suggests poisoning.

The gastrointestinal tract is often analyzed first,

followed by urine.
Analysis focuses on the tissues of organs where the
concentration of drugs may be the greatest.
Specimens should be collected as soon as possible
after death.
Presumptive testing is performed first to detect the
presence or absence of drugs.

Interpretation of toxicological information



The toxicologist must determine how the poison

entered the body and whether enough poison was
ingested to cause death.
The highest concentration of poison is usually found
where it entered the body.
Toxicology analysis may be able to estimate when the
poison was dispensed.