Page 121 - CFDI Guide

CFDI SPECIAL MODULES IN DEATH / SBI CRIMINAL DEFENSE INVESTIIGATIONS

Understanding Forensic Toxicology

I. Investigating Drug Deaths / Overdoses
Toxicology is the scientific study of poisons, their actions, and analysis – pharmacology and toxicology.

The Forensic Pathologist has medical education and training in toxicology as it relates to pathology,
and the Cause and Manner of Death. A Fellow in Forensic Toxicology holds a PhD and is Board Certified

by the American Board of Forensic Toxicology and includes Forensic Toxicology, Forensic Alcohol
Toxicology, and Forensic Drug Toxicology.

Like forensic pathology in medicine, forensic toxicology is a science and uses scientific principles and

methodologies. In death investigation, the circumstances of medical history, social history, body

position and clothing, and medications are considered with the toxicology.

Toxicology is routine in autopsies. Specimens collected are blood, urine, and vitreous humour (eye

fluid) – each for specific reasons, with specific tests, and specific interpretation. Other specimens

collected are liver, kidney, bile, stomach contents, muscle – decomposed or otherwise compromised
decedents may have limited specimen options. When submitted, the request to the laboratory will

include the specimen type and location collected. For example, peripheral blood (those from outlying
arteries – arms, legs, etc.) vs. cardiac blood have different processes and interpretations. Specimens

collected from organs and muscles also have different processes and interpretations.

Interpretation of toxicology is with all available data, including the scene and decedent. A toxic level of
drugs in one person may not be fatal in chronic abusers. A mixture of drugs in non-fatal levels

(‘cocktail’ or multi-drug toxicity) otherwise therapeutic individually may be fatal. Other drug reactions,
side effects, or decedent reactions of therapeutic levels may be fatal. Drugs may be fatal the first time

of use, or after years of use, and may be fatal hours to days after use. The determination of Suicide vs.
Accident overdose depends on history and evidence. Homicide – poisoning – is rare and requires

investigative evidence, opportunity, and means – and may not be in a routine post-mortem drug
screen.

Toxicology is about chemistry and not limited to drugs. Gases (i.e. carbon monoxide) and common

products (i.e. anti-freeze) may be fatal. Any drug may be abused, and common over-the-counter drugs
may be fatal (i.e. Acetaminophen – Tylenol). Common drugs of abuse, including prescription and illicit,

101 | P a g e