Location of Repository

An Investigation into the Distribution and Concentration of Drugs of Abuse within Different Body Compartments and Relationship with Toxicity

By Salah Ali Menshawi


Pages 199-201 of Appendix I have been removed from the electronic version of this thesis due to copyright restrictions. The full version can be consulted at the University of Leicester Library.Femoral blood is preferable in post-mortem toxicological analysis but may not always be available. Alternative specimens such as cardiac blood, vitreous humour, stomach contents, bile, urine, hair, bone, liver and muscle may be used. However, only limited data are available for the interpretation of drug concentrations in these alternative specimens. The aim of the study was to investigate the distribution of drugs in different body compartments in relation to levels in femoral blood and their toxicity. All post-mortem specimens from 95 subjects were provided by Professor M Tsokos, Institute of Legal Medicine, Germany. Ethanol was measured by gas chromatography, whilst other drugs of abuse were initially screened for by immunoassays (in blood, hair and bone by Cozart drug immunoassay kit; urine by cloned enzyme donor immunoassay). A general drug screen and confirmation was performed on all specimens using gas chromatography/mass spectrometry and drug quantification was by high-pressure liquid chromatography-tandem mass spectrometry. Drug levels in femoral blood and median concentration ratios in relation to femoral blood (range) were as follows: ethanol 4-365mg/dL, median ratios for cardiac blood 1.9 (0.8:1-42.3:1), vitreous humour 1.6 (0.7:1-9.4:1), urine 6.5 (1.7:1-153:1) and bile 11.3 (1.0:1-34:1); for cocaine 5-2413ng/ml, median ratios for cardiac blood 1.2 (0.2:1-7.0:1), vitreous humour 1.4 (1.0:1-3.3:1), urine 4.9 (0.4:1->1000:1) and bile 7.0 (0.6:1-41.6:1); for methadone 7-1795 ng/ml, median ratios for cardiac blood 1.4 (0.6:1->3.9:1), vitreous humour 0.7 (0.04:1-0.99:1), urine 0.7 (0.3:1->3.9:1) and bile 2.9 (0.7:1->9.6:1); for morphine 7-1756 ng/ml, median ratios for cardiac blood 2.0 (0.9:1-11.5:1), vitreous humour 1.0 (0.4:1-18.5:1), urine 2.2 (0.1:1-56:1) and bile 24 (1.3:1 -> 195:1). Similarly, in liver and muscle for cocaine the median concentration ratio in ml/g was 0.2 (0.04:1-1.0:1) and 0.1 (0.1:1-2.5:1) respectively; for methadone 0.3 (0.2:1-<0.7:1) and 0.1 (0.05:1->0.7:1) respectively; and for morphine 0.6 (0.1:1-1.6:1) and 0.3 (0.1:1-1.6:1) respectively. In the majority of cases there was a good correlation between femoral blood levels and the concentration in other body compartments. This study has added to our knowledge and understanding of the usefulness of using alternative post-mortem specimens to study the distribution of drugs of abuse in different body compartments and how the concentrations relate to femoral blood levels and toxicity

Publisher: University of Leicester
Year: 2010
OAI identifier: oai:lra.le.ac.uk:2381/8572

Suggested articles



  1. (2006). [Hemoptysis in a young man].
  2. (2001). [The heart and cocaine].
  3. (2007). 10/3/2009) New Tests from 2006-07 Indicate that Mitch Collins Orally Consumed Heroin. Retrieved 10/3,
  4. (2001). 11)] Cocaine: PET studies of cocaine pharmacokinetics, dopamine transporter availability and dopamine transporter occupancy.
  5. (2008). 31/7/2002) Preventable Adverse Drug Reactions: A Focus on Drug Interactions.&quot;
  6. (1995). A comparison of drug concentrations in postmortem cardiac and peripheral blood in 320 cases.&quot;
  7. (1987). A comparison of postmortem heart blood and femoral blood ethyl alcohol concentrations.
  8. (2002). A fatal case of cocaine poisoning in a body packer.
  9. (2004). A fatal overdose of cocaine associated with coingestion of marijuana, buprenorphine, and fluoxetine. Body fluid and tissue distribution of cocaine and its metabolites determined by hydrophilic interaction chromatographymass spectrometry (HILIC-MS).
  10. (1996). A high fatal postmortem blood concentration of cocaine in a drug courier.
  11. (2002). A rapid GC-MS method for the determination of dihydrocodeine, codeine, norcodeine, morphine, normorphine and 6-MAM in urine.
  12. (2002). A review of methadone deaths in Jefferson County,
  13. (1990). A study on the correlation of blood and vitreous humour alcohol levels in the late absorption and elimination phases.
  14. (1984). A study using body fluids to determine blood alcohol.
  15. (1993). ACP Broadsheet no 137:
  16. (2007). Acute aortic dissection associated with use of cocaine.
  17. (2002). Acute aortic dissection related to crack cocaine.
  18. (1988). Acute renal failure due to rhabdomyolysis associated with cocaine toxicity.
  19. (2002). Alcohol and benzodiazepines in fatal poisonings.
  20. (2006). Alcohol distribution in different postmortem body fluids.
  21. (1995). Alcoholic ketoacidosis as a cause of death in forensic cases.
  22. (1979). Alcoholism and cerebrovascular thrombosis in the young.
  23. (2000). Alpha 1-acid glycoprotein (AAG) and serum protein binding of methadone in heroin addicts with abstinence syndrome.
  24. (2001). Alternate strategies for postmortem drug testing.
  25. (1993). An animal model of postmortem amitriptyline redistribution.
  26. (2000). An approach to drug abuse, intoxication and withdrawal.
  27. (2007). An overview of non-cardiac cocaine toxicity.
  28. (2005). An unusual case of post-mortem redistribution of ethanol.
  29. (1985). An unusually high blood morphine concentration in a fatal case.
  30. (1991). Analysis of cocaine and cocaethylene in blood and tissues by GC-NPD and GC-ion trap mass spectrometry.
  31. (1999). Analysis of race effects on drug-test results.
  32. (2007). Analytical and Practical Aspects of Drug Testing in Hair. Boca
  33. (2005). Analytical toxicology: guidelines for sample collection postmortem.
  34. (1976). Antemortem conversion of codeine to morphine in man.
  35. (2005). Assessment of UDP-glucuronosyltransferase catalyzed formation of ethyl glucuronide in human liver microsomes and recombinant UGTs.&quot;
  36. (1982). Automated determination of alcohol in blood using the ADH method.
  37. (2002). Behavioral neurobiology of alcohol addiction: recent advances and challenges.
  38. (1999). Benzodiazepines. Retrieved
  39. (2000). Beta-hydroxybutyric acid-an indicator for an alcoholic ketoacidosis as cause of death in deceased alcohol abusers.
  40. (2007). Bile analysis in heroin overdose.&quot;
  41. (2002). Bile analysis of drugs in postmortem cases.
  42. (1990). Binding of d-methadone, l-methadone, and dl-methadone to proteins in plasma of healthy volunteers: role of the variants of alpha 1-acid glycoprotein.
  43. (2004). Bioanalytical Method Validation.
  44. (1975). Blood codeine concentrations in fatalities associated with codeine.
  45. (1987). Body temperature influences on ethanol elimination rate.
  46. (1985). Brain concentrations of cocaine and benzoylecgonine in fatal cases.
  47. (2008). Can serum beta-hydroxybutyrate be used to diagnose diabetic ketoacidosis?.
  48. (1995). Cardiac complications of cocaine abuse.
  49. (2003). Cardiovascular disorders associated with cocaine use: myths and truths.
  50. (1995). Cardiovascular effects of cocaine in humans: laboratory studies.
  51. (2008). Casarett & Doull's Toxicology: The Basic Science of Poisons Kensas Cit, Kensas, McGraw-Hill Companies,
  52. (2003). Casarett and Doull's Essentials of Toxicology.
  53. (2001). Casarett and Doull's Toxicology The Basic Science Of Poisions.
  54. (1987). Central and peripheral cocaine receptors.
  55. (2002). Characterization of methadone overdose: clinical considerations and the scientific evidence.
  56. (2005). Chronic drug exposures during development in nonhuman primates: models of brain dysfunction in humans.
  57. (2000). Chronic hypnotic use: deadly risks, doubtful benefit. Review Article.
  58. (2004). Clarke's Analysis of Drugs and Poisons in pharmaceuticals, body fluids and postmortem material,
  59. (2008). Clarke's Analytical Forensic Toxicology,
  60. (1994). Clinical pharmacokinetics of benzodiazipines.
  61. (1989). Clinical pharmacokinetics of nonopiate abused drugs.
  62. (2004). Clinician's Pocket Reference (LANGE Clinical Science). North America, The McGraw Hill companies.
  63. (2004). Club drugs: MDMA, gamma-hydroxybutyrate (GHB), Rohypnol, and ketamine.
  64. (1999). Cocaine absorption after application of a viscous cocaine-containing TAC solution.
  65. (1995). Cocaine abuse in methadone maintenance
  66. (1993). Cocaine abuse.
  67. (1999). Cocaine and apoptosis in myocardial cells.
  68. (2005). Cocaine and heroin ('speedball') self-administration: the involvement of nucleus accumbens dopamine and mu-opiate, but not delta-opiate receptors.
  69. (2005). Cocaine and its metabolites. Drugs and Poisons in Humans A Handbook of Practical Analysis Berlin,
  70. (1992). Cocaine and metabolite concentrations in the hair of South American coca chewers.
  71. (2007). Cocaine and metabolites urinary excretion after controlled smoked administration.
  72. (2005). Cocaine and the heart.
  73. (2009). Cocaine cardiotoxicity: a review of the pathophysiology, pathology, and treatment options.
  74. (1996). Cocaine excretion in the semen of drug users.
  75. (1990). Cocaine fatality: an unexplained blood concentration in a fatal overdose.
  76. (1998). Cocaine metabolism and urinary excretion after different routes of administration.
  77. (1999). Cocaine pharmacokinetics in men and in women during the follicular and luteal phases of the menstrual cycle.
  78. (1988). Cocaine use in Amsterdam in non-deviant subcultures.
  79. (1989). Cocaine- and methamphetamine-related deaths in San Diego County
  80. (2007). Cocaine-related acute aortic dissection: patient demographics and clinical outcomes.
  81. (2005). Cocaine-related torsade de pointes in a methadone maintenance patient.
  82. (1988). Cocaine: analysis, pharmacokinetics, and metabolic disposition.
  83. (1991). Cocaine: Pharamacology, Physiology, and Clinical Strategies Florida,
  84. (2000). Codeine analgesia is due to codeine-6-glucuronide, not morphine.
  85. (1999). Codeine concentration in hair after oral administration is dependent on melanin content.
  86. (2004). Codeine intoxication associated with ultrarapid CYP2D6 metabolism.
  87. (2005). Comparative alcohol concentrations in blood and vitreous fluid with illustrative case studies.
  88. (1995). Comparative investigation of drug concentrations in cerebrospinal fluid, vitreous humor and blood. TIAFT/SOFT Joint Congress on Forensic Toxicology,
  89. (1984). Comparative study of postmortem barbiturates, methadone, and morphine in vitreous humor, blood, and tissue.
  90. (1975). Comparative toxicology in vitreous humor and blood.
  91. (2003). Comparison of blood ethanol concentration in deaths attributed to acute alcohol poisning and chronic alcoholism.
  92. (2006). Comparison of ethanol concentrations in right cardiac blood, left cardiac blood and peripheral blood in a series of 30 cases.
  93. (2007). Comparison of various international guidelines for analytical method validation.
  94. (2009). Complications of cocaine addiction.
  95. (1996). Comprehensive Review in Toxicology for Emergency Clinicians.
  96. (1989). Computer-assisted interpretation in forensic toxicology: morphine-involved deaths.
  97. (2006). Concise Clinical Pharmacology,
  98. (1997). Concordance between self-reported drug use and findings in hair about cocaine and heroin.
  99. (2007). Crack whips the heart: a review of the cardiovascular toxicity of cocaine.
  100. (2007). Critical care sedation for neuroscience patients.
  101. (1998). Dead sober or dead drunk?.
  102. (1990). Deaths of heroin addicts starting on methadone maintenance.
  103. (2006). Determination of drugs of abuse and their metabolites in human plasma by liquid chromatography-mass spectrometry: An application to 156 road fatalities.
  104. (2006). Determination of ethanol concentrations from bile and its importance in forensic medicine.
  105. (2006). Determination of morphine in postmortem rabbit bone marrow and comparison with blood morphine concentrations.
  106. (1996). Determination of morphine, morphine-3-glucuronide and morphine-6-glucuronide in human serum by solid-phase extraction and liquid chromatography-mass spectrometry with electrospray ionisation.
  107. (1999). Determination of morphine, morphine-3-glucuronide, and morphine-6-glucuronide in plasma after intravenous and intrathecal morphine administration using HPLC with electrospray ionization and tandem mass spectrometry.
  108. (2001). Determination of opiates in postmortem bone and bone marrow.
  109. (1996). Determination of volume of distribution for ethanol in male and female subjects.
  110. (2006). Development and validation of a gas chromatography-mass spectrometry assay for opiates and cocaine in human teeth.
  111. (1986). Diazepam and methadone blood levels following concurrent administration of diazepam and methadone.
  112. (1981). Diazepam use among methadone maintenance patients: patterns and dosages.
  113. (2005). Different accumulation of temocapril and enalapril during repeated dosing in elderly patients.
  114. (1998). Discriminative stimulus effects of a cocaine/heroin &quot;speedball&quot; combination in rhesus monkeys.
  115. (1985). Disposition of cocaine in fatal poisoning in man.
  116. (1995). Disposition of toxic drugs and chemicals in man,
  117. (2004). Disposition of Toxic Drugs and Chemicals in Man.
  118. (1992). Distribution and kinetics of carbon-11-cocaine in the human body measured with PET.
  119. (1997). Distribution of free and conjugated morphine in body fluids and tissues in a fatal heroin overdose: is conjugated morphine stable in postmortem specimens?.
  120. (2005). Distribution of methadone and EDDP in 100 postmortem cases. Society of Forensic Toxicologists,
  121. (1986). Distribution of morphine in body fluids and tissues in fatal overdose.
  122. (1978). Does ethanol intoxication promote brain Infarction in young adults?.
  123. (1998). Dose-concentration relationships in hair from subjects in a controlled heroin-maintenance program.
  124. (2005). Dose-related distribution of codeine, cocaine, and metabolites into human hair following controlled oral codeine and subcutaneous cocaine administration.
  125. (2006). Drug abuse and infection.
  126. (2007). Drug Abuse Hanbook.
  127. (2006). Drug Abuse Handbook,
  128. (1999). Drug and Alcohol Abuse: A Clinical Guide to Diagnosis and Treatment (Critical Issues in Psychiatry)
  129. (2001). Drug and chemical bloodlevel data
  130. (2004). Drug Court Practitioner. Urine Drug Concentrations: The Scientific Rational For Eliminating The Use Of Drug Test Levels In Drug Court Proceeding.
  131. (2008). Drug Testing in Alternate Biological Specimens,
  132. (1999). Drug testing with alternative matrices II. Mechanisms of cocaine and codeine deposition in hair.
  133. (2005). Drug Tolerance, Drug Addiction, and Drug Anticipation.
  134. (2001). Drugs in postmortem adipose tissues: evidence of antemortem deposition.
  135. (2007). Drugs that damage the liver.
  136. (2003). Effect of post-mortem changes on peripheral and central whole blood and tissue clozapine and norclozapine concentrations in the domestic pig (Sus scrofa).
  137. (2007). Effects of d-amphetamine and buprenorphine combinations on speedball (cocaine+heroin) self-administration by rhesus monkeys.
  138. (1995). Effects of single and multiple intravenous cocaine injections in humans maintained on methadone.
  139. (2005). Elevated postmortem ethanol concentrations in an insulindependent diabetic.
  140. (2007). Elimination. Elimination in the Urine Retrieved 7/5, 2008, from http://www.merck.com/mmhe/sec02/ch011/ch011f.html?qt=Urine%20acidity&alt=s
  141. (2000). Encyclopedia of Forensic Sciences.
  142. (1996). Enhancement of cocaine's abuse liability in methadone maintenance patients.
  143. (2004). Environmental Contaminants: Assessment and Control
  144. (2000). Estimating antemortem drug concentrations from postmortem blood samples: the influence of postmortem redistribution.
  145. (1992). Ethanol distribution ratios between urine and capillary blood in controlled experiments and in apprehended drinking drivers.
  146. (2004). Ethanol formation in unadulterated postmortem tissues.
  147. (2006). Ethanol production by Candida albicans in postmortem human blood samples: effects of blood glucose level and dilution.
  148. (2009). Evaluation of EDDP (Methadone metabolite) results. from http://protocols.sonichealthcare.com/shared/IP250.pdf.
  149. (1982). Evaluation of ethanol concentrations in decomposed bodies.
  150. (1991). Evidence for a role for dopamine in the diazepam locomotor stimulating effect.
  151. (2000). Evidence for bias in hair testing and procedures to correct bias.
  152. (2005). Excited Delirium Syndrome:
  153. (2004). Excretion.&quot;
  154. (2005). Factors affecting drug absorption and distribution.
  155. (2004). Fatal blood and tissue concentrations of more than 200 drugs.
  156. (2000). Fatal heroin overdoses resulting from non-injecting routes of administration,
  157. (1993). Fatal poisonings attributed to benzodiazepines in Britain during the 1980s.
  158. (1994). Food-induced lowering of blood-ethanol profiles and increased rate of elimination immediately after a meal.
  159. (1991). Forensic drug testing for opiates: I. Detection of 6-acetylmorphine in urine as an indicator of recent heroin exposure; drug and assay considerations and detection times.
  160. (1991). Forensic drug testing for opiates. II. Metabolism and excretion rate of morphine in humans after morphine administration.
  161. (1996). Frequent distribution of ultrarapid metabolizers of debrisoquine in an ethiopian population carrying duplicated and multiduplicated functional CYP2D6 alleles.
  162. (1985). Functional control of the delta-opiate receptor by the inhibitory guanine nucleotide-binding protein.
  163. (2001). Goodman and Gilman's The Pharmacological Basis of Therapeutics.
  164. (2004). Guide to Obtaining Specimens at Post-mortem for Analytical Toxicology. Retrieved 11/5,
  165. (1997). Habitual, toxic, and lethal concentrations of 103 drugs of abuse in humans.
  166. (1993). Hair analysis as evidence in forensic cases.
  167. (2000). Hair analysis by immunological methods from the beginning to 2000. Forensic Sci Int
  168. (1999). Hair analysis for abused and therapeutic drugs.
  169. (1992). Hair analysis for drugs of abuse. V. The facility in incorporation of cocaine into hair over its major metabolites, benzoylecgonine and ecgonine methyl ester.
  170. (1994). Hair analysis for drugs of abuse. VII. The incorporation rates of cocaine, benzoylecgonine and ecgonine methyl ester into rat hair and hydrolysis of cocaine in rat hair.
  171. (1995). Hair analysis for drugs of abuse. X. Effect of physicochemical properties of drugs on the incorporation rates into hair.
  172. (2001). Hair testing for drugs of abuse: evaluation of external cocaine contamination and risk of false positives.
  173. (1980). Hazardous alcohol consumption and diseases of the circulatory system.
  174. (2004). Heroin profiling: mannitol hexaacetate as an unusual ingredient of some illicit drug seizures.
  175. (1984). Heroin-related deaths: new epidemiologic insights.
  176. (2007). High hepatitis C virus prevalence and incidence among Canadian intravenous drug users.
  177. (1990). High-performance liquid chromatography with column switching for the determination of cocaine and benzoylecgonine concentrations in vitreous humor.
  178. (2008). Hypertensive Emergencies: Acute Care Evaluation and
  179. (2008). Illicit methadone use and abuse in young people accessing treatment for opiate dependence.
  180. (2008). Improved understanding of the effect of food on drug absorption and bioavailability for lipophilic compounds using an intestinal pig perfusion model.
  181. (1996). Incorporation of isotopically labeled cocaine and metabolites into human hair: 1. dose-response relationships.
  182. (1998). Incorporation of isotopically labeled cocaine into human hair: race as a factor.
  183. (1996). Influence of plasmaprotein binding on analgesic effect of methadone in rats with spontaneous withdrawal.
  184. (1997). Influence of renal failure on the disposition of morphine, morphine-3-glucuronide and morphine-6-glucuronide in sheep during intravenous infusion with morphine.
  185. (1990). Inpatient versus outpatient cocaine abuse treatments.
  186. (1978). Interaction of methadone and ethanol metabolism.
  187. (2000). Interpretation of blood cocaine and metabolite concentrations.
  188. (2005). Interpretation of postmortem alcohol concentrations.
  189. (2007). Interpreting results of ethanol analysis in postmortem specimens: a review of the literature.
  190. (1991). Interstitial pneumonitis associated with &quot;crack&quot; cocaine abuse.
  191. (2000). Intracerebral haemorrhage and drug abuse in young adults.
  192. (1980). Intranasal and oral cocaine kinetics.
  193. (2006). Intravenous cocaine and QT variability.
  194. (1996). Involvement of codeine in drug-related deaths.
  195. (2005). Is there a common molecular pathway for addiction?
  196. (2002). Karch's Pathology of Drug Abuse,
  197. (2005). Key concepts in postmortem drug redistribution.
  198. (1983). Kinetics of cocaine in humans after intravenous and intranasal administration.
  199. (1998). L-Methadone and D,L-methadone in methadone maintenance treatment: a comparison of therapeutic effectiveness and plasma concentrations.
  200. (1997). Lack of predictable site-dependent differences and time-dependent changes in postmortem concentrations of cocaine, benzoylecgonine, and cocaethylene in humans.
  201. (2000). Lethal seizures predicted after aminophylline therapy in cocaine abusers.
  202. (2000). Liquid chromatography-mass spectrometry in forensic toxicology.
  203. (1999). Liquid chromatography-mass spectrometry: potential in forensic and clinical toxicology.
  204. (1996). Local anaesthesia in flexible nasendoscopy. A comparison between cocaine and co-phenylcaine.
  205. (1988). Local anaesthetic actions of cocaine: effects on excitatory and inhibitory synaptic responses in the hippocampus in vitro.
  206. (2007). Loss of ethanol from vitreous humor in drowning death.
  207. (2001). Manual of Family Practice Lippincott Williams
  208. (1998). Mechanisms of alcohol-related strokes. Novartis Found Symp 216: 193-204; discussion
  209. (1986). Mechanisms of depressant drug action/interaction.
  210. (1993). Mechanisms of drug incorporation into hair.
  211. (2003). Mechanisms underlying postmortem redistribution of drugs: a review.
  212. (2002). Medical Pharmacology: A Clinical Core Text for Integrated Curricula Elsevier Health Sciences.
  213. (2003). Medical-Legal Aspects of Alcohol, Lawyers and Judges Publishing.
  214. (1996). Medico-Legal Aspects of Alcohol
  215. (1972). Metabolism of alcohol (ethanol) in man.
  216. (1993). Methadone and drug addicts.
  217. (2003). Methadone and Metabolite Urine Concentrations in Patients Maintained on Methadone.
  218. (1973). Methadone binding to human plasma proteins.
  219. (2000). Methadone deaths: a toxicological analysis.
  220. (1975). Methadone in man: pharmacokinetic and excretion studies in acute and chronic treatment.
  221. (2003). Methadone Matters Evolvivng Practice of Community Methadone Treatment of Opiate Addiction, Informa Healthcare.
  222. (1973). Methadone plasma level: sustained by a reservoir of drug in tissue.
  223. (2005). Methadone related death Retrieved 10/01,
  224. (2007). Methadone toxicity fatalities: a review of medical examiner cases in a large metropolitan area.
  225. (1969). Methadone treatment of randomly selected criminal addicts.
  226. (1974). Methadone--a cause of death.
  227. (2004). Methadone--metabolism, pharmacokinetics and interactions.
  228. (2006). Methadone-Drug* Interactions.
  229. (2004). Methadone-related deaths in Palm Beach County.
  230. (2000). Misleading results of ethanol analysis in urine specimens from rape victims suffering from diabetes.
  231. (2005). Modes of drug elimination.
  232. (2001). Molecular basis of long-term plasticity underlying addiction.
  233. (2004). Molecular mechanisms of drug addiction.
  234. (1974). Morphine concentrations in blood and organs in cases of fatal poisoning.
  235. (1990). Morphine in postmortem blood: its importance for the diagnosis of deaths associated with opiate addiction.
  236. (1981). Morphine kinetics in cancer patients.
  237. (1993). Morphine pharmacokinetics and metabolism in humans. Enterohepatic cycling and relative contribution of metabolites to active opioid concentrations.
  238. (2006). MORPHINE TARTRATE. Retrieved 15/5,
  239. (1999). Mortality associated with New South Wales methadone programs in 1994: lives lost and saved.
  240. (2006). Nanotribological and nanomechanical characterization of human hair using a nanoscratch technique.
  241. (2002). Neonatal hair analysis for benzoylecgonine: a sensitive and semiquantitative biological marker for chronic gestational cocaine exposure.
  242. (2008). New Statement on Cocaine-Associated MI Urges Caution With Beta Blockers, Emphasizes Kicking the Habit.&quot;
  243. (1998). On the influence of postmortem alcohol diffusion from the stomach contents to the heart blood.
  244. (2003). Opioids-Effects on Human Performance and Behavior.
  245. (1985). Oral morphine in cancer patients: in vivo kinetics and in vitro hepatic glucuronidation.
  246. (2001). Organic anion-transporting polypeptide B (OATP-B) and its functional comparison with three other OATPs of human liver.
  247. (1997). Patterns of drug use in dependent opioid users in methadone treatment.
  248. (2003). Pharmaceutical Calculations: The Pharmacist's Handbook, Lippincott Williams
  249. (1999). Pharmacokinetic modeling of M6G formation after oral administration of morphine in healthy volunteers.
  250. (1997). Pharmacokinetic optimisation of opioid treatment in acute pain therapy.
  251. (2008). Pharmacokinetics and Pharmacodynamics of Abused Drugs California,
  252. (1995). Pharmacokinetics and pharmacodynamics of cocaine.
  253. (2000). Pharmacokinetics and pharmacodynamics of inhaled versus intravenous morphine in healthy volunteers.
  254. (1994). Pharmacokinetics and pharmacodynamics of smoked heroin.
  255. (2006). Pharmacokinetics and pharmacokinetic variability of heroin and its metabolites: review of the literature.
  256. (1991). Pharmacokinetics of codeine and its metabolites in Caucasian healthy volunteers: comparisons between extensive and poor hydroxylators of debrisoquine.
  257. (1996). Pharmacokinetics of morphine and its glucuronides after intravenous infusion of morphine and morphine-6-glucuronide in healthy volunteers.
  258. (1989). Pharmacokinetics of the newer benzodiazepines.
  259. (1999). Pharmacological and biochemical interactions between opioids and cannabinoids.
  260. (2001). Physiological, subjective and reinforcing effects of oral and intravenous cocaine in humans.
  261. (2000). Pitfalls in forensic toxicology.
  262. (1986). Plasma protein binding of drugs Implications for therapeutic drug monitoring.
  263. (1997). Possible markers for postmortem drug redistribution.
  264. (1992). Post-mortem alcohol analysis of blood, urine, vitreous humor and bile. 39th annual meeting, Canadian Society of Forensic Science,
  265. (2009). Post-mortem toxicology of commonly-abused drugs.
  266. (2003). Post-mortem toxicology: what the dead can and cannot tell us.
  267. (2007). Post-mortem toxicology.
  268. (1991). Postmortem absorption of drugs and ethanol from aspirated vomitus--an experimental model.
  269. (1997). Postmortem alcohol analysis of the synovial fluid and its availability in medico-legal practices.
  270. (2002). Postmortem blood and vitreous humor ethanol concentrations in a victim of a fatal motor vehicle crash.
  271. (1995). Postmortem diffusion of alcohol from the stomach.
  272. (1996). Postmortem diffusion of drugs from gastric residue: an experimental study.
  273. (2001). Postmortem diffusion of drugs from the bladder into femoral venous blood.
  274. (1997). Postmortem diffusion of tracheal lidocaine into heart blood following intubation for cardiopulmonary resuscitation.
  275. (1988). Postmortem disposition of morphine in rats.
  276. (1996). Postmortem distribution and redistribution of morphine in man.
  277. (2004). Postmortem distribution of heroin metabolites in femoral blood, liver, cerebrospinal fluid, and vitreous humor.
  278. (1996). Postmortem distribution pattern of morphine and morphine glucuronides in heroin overdose.
  279. (1999). Postmortem drug redistribution--human cases related to results in experimental animals.
  280. (2004). Postmortem morphine concentrations following use of a continuous infusion pump.
  281. (1996). Postmortem production of ethanol and factors that influence interpretation: a critical review.
  282. (2005). Postmortem production of ethanol in different tissues under controlled experimental conditions.
  283. (1989). Postmortem redistribution of drugs Advances in analytical toxicology 2:
  284. (2000). Postmortem redistribution of morphine and its metabolites.
  285. (1994). Postmortem release of amitriptyline from the lungs; a mechanism of postmortem drug redistribution.
  286. (1996). Postmortem stability of cocaine and cocaethylene in blood and tissues of humans and rabbits.
  287. (1995). Postmortem tissue samples: an alternative to urine and blood for drug analysis in racehorses.
  288. (2007). Postmortem Toxicology of Abused Drugs.
  289. (2004). Postmortem toxicology of drugs of abuse.
  290. (2003). Principles of Forensic Toxicology,
  291. (2007). Quantitative analysis of cocaine and its metabolites in whole blood and urine by high-performance liquid chromatography coupled with tandem mass spectrometry.
  292. (2001). Reactions and Enzymes. Oxidation/Reduction Retrieved 2/12,
  293. (1999). Redistribution of basic drugs into cardiac blood from surrounding tissues during early-stages postmortem.
  294. (1998). Relating cocaine blood concentrations to toxicity-an autopsy study of 99 cases.
  295. (2005). Relation of postmortem blood alcohol and drug concentrations in fatal poisonings involving amitriptyline, propoxyphene and promazine.
  296. (2006). Relationships between concentrations of cocaine and its hydrolysates in peripheral blood, heart blood, vitreous humor and urine.
  297. (1985). Risk factors for subarachnoid hemorrhage.
  298. (2006). Role of acetaldehyde in mediating the pharmacological and behavioral effects of alcohol.
  299. (1977). Self-poisoning with barbiturates in England and Wales during 1959-74.
  300. (2004). Sex differences in the escalation of intravenous cocaine intake following long- or short-access to cocaine self-administration.
  301. (1996). Significance of bile analysis in drug-induced deaths.
  302. (1999). Simultaneous assay of morphine, morphine-3-glucuronide and morphine-6-glucuronide in human plasma using normal-phase liquid chromatography-tandem mass spectrometry with a silica column and an aqueous organic mobile phase.
  303. (1997). Simultaneous determination of acetylcodeine, monoacetylmorphine, and other opiates in urine by GC-MS.
  304. (1993). Simultaneous determination of drugs of abuse (opiates, cocaine and amphetamine) in human hair by GC/MS and its application to a methadone treatment program.
  305. (1981). Single dose pharmacokinetics and bioavailability of methadone in man studied with a stable isotope method.
  306. (1993). Site dependence of methamphetamine concentrations in blood samples collected from cadavers of people who had been methamphetamine abusers.
  307. (1997). Site-to-site variability of drug concentrations in skeletal muscle.
  308. (2009). ST Elevation Alternans in Presence of Profound Myocardial Ischemia and Injury Induced by Cocaine Toxicity.
  309. (1998). Stability of nitrobenzodiazepines in postmortem blood.
  310. (2006). Stages of Acute Alcoholic Influnce/Intoxication from http://www.intox.com/physiology.asp.
  311. (2000). Status of alcohol absorption in drinking drivers killed in traffic accidents.
  312. (2007). Stimulant-induced enhanced sexual desire as a potential contributing factor in HIV transmission.
  313. (1999). Storage of specimens at 4 degrees C or addition of sodium fluoride (1%) prevents formation of ethanol in urine inoculated with Candida albicans.
  314. (2007). Stroke in young adults who abuse amphetamines or cocaine: a population-based study of hospitalized patients.
  315. (1964). Subarachnoidal haemorrhage and sudden unexpected death.
  316. (2004). Sublingual misoprostol versus methylergometrine for active management of the third stage of labor.
  317. (2000). Substance Abuse and Hypertension.
  318. (1985). Substance Abuse Problems: New Issues for the 80s
  319. (2009). Sudden death associated with intravenous injection of toad extract.
  320. (1992). Survey of drugrelated deaths in Victoria.
  321. (1982). Survival after a serum ethanol concentration of 1 1/2%.
  322. (1980). Systematic review of the benzodiazepines.
  323. (1991). Testing human hair for drugs of abuse. III. Identification of heroin and 6-acetylmorphine as indicators of heroin use.
  324. (2005). The ABCs of Pharmacokinetics.
  325. (2002). The cocaine &quot;body stuffer&quot; syndrome: a fatal case.
  326. (1980). The comparison of alcohol concentrations in postmortem fluids and tissues.
  327. (2003). The detection of morphine and codeine in human teeth: an aid in the identification and study of human skeletal remains.
  328. (1996). The disposition of morphine and its 3-and 6-glucuronide metabolites in humans and animals, and the importance of the metabolites to the pharmacological effects of morphine.
  329. (1992). The distribution of ethanol in postmortem blood specimens.
  330. (1980). The effect of chronic ethanol consumption on pathways of ethanol metabolism.
  331. (1974). The effect of diazepam on the metabolism of methadone by the liver of methadone-dependent rats.
  332. (1996). The effect of postmortem interval on the concentrations of cocaine and cocaethylene in blood and tissues: an experiment using rats.
  333. (2000). The effects of exercise on the pharmacokinetics of drugs.
  334. (2004). The effects of methadone and its role in fatalities. Human Psychopharmacology:
  335. (2001). The Forensic Pharmacology of Drugs of Abuse,
  336. (1990). The forensic science implications of site and temporal influences on postmortem blood-drug concentrations.
  337. (1994). The in vitro differential binding of benzoylecgonine to pigmented human hair samples
  338. (2000). The incorporation of cocaine and metabolites into hair: effects of dose and hair pigmentation.
  339. (2006). The influence of collection site and methods on postmortem morphine concentrations in a porcine model.
  340. (1983). The influence of physical properties and lipid content of bile on the human blood/bile ethanol ratio.
  341. (1999). The influences of age and gender on blood ethanol concentrations in healthy humans.
  342. (1993). The investigation of beta-hydroxybutyrate as a marker for sudden death due to hypoglycemia in alcoholics.
  343. (1987). The measurement and interpretation of morphine in blood.
  344. (1994). The origin and significance of ecgonine methyl ester in blood samples.
  345. (2000). The pharmacokinetics of morphine and morphine glucuronide metabolites after subcutaneous bolus injection and subcutaneous infusion of morphine.
  346. (2003). The pharmacology of cocaethylene in humans following cocaine and ethanol administration.
  347. (1994). The Pharmacology of Local Anaesthetic Agents Retrieved 2/5,
  348. (1999). The physiological and pharmacological roles of cytochrome P450 isoenzymes.
  349. (1984). The rate and kinetic order of ethanol elimination.
  350. (2006). The redistribution of selected psychiatric drugs in post-mortem cases.
  351. (2005). The relationship of a high level of serum beta-hydroxybutyrate to cause of death.
  352. (2006). The Renal System at a Glance (At a Glance). Hong Kong,
  353. (2005). The role of cocaine in heroin-related deaths. Hypothesis on the interaction between heroin and cocaine.
  354. (1990). The role of ethanol abuse in the etiology of heroin-related death.
  355. (1995). The role of ethanol in heroin deaths.
  356. (1999). The role of liquid chromatography-mass spectrometry in the determination of heroin and related opioids in biological fluids.
  357. (1975). The toxicology of twelve cases of death involving methadone: examination of postmortem specimens.
  358. (1992). The use of plasma levels to optimize methadone maintenance treatment.
  359. (2001). Therapeutic drug monitoring in methadone maintenance: choosing a matrix.
  360. (2003). Time-adjusted urine/blood ratios of ethanol in drinking drivers.
  361. (2006). Toxicity, Cocaine. Retrieved 24/07/2007,
  362. (2002). Toxicological interactions between alcohol and benzodiazepines.
  363. (2003). Toxicological interactions involving psychiatric drugs and alcohol: an update.
  364. (2000). Toxicology and pathology of deaths related to methadone: retrospective review.
  365. (2000). Traffic Safety Facts 2000. A Compilation of Motor Vehicle Crash Data from the Fatality Analysis Reporting System and the General Estimates System.
  366. (1999). Treatment For Stimulant Use Disorders: A Treatment Improvement Protocol by
  367. (1998). Unacceptably high site variability in postmortem blood alcohol analysis.
  368. (2004). Understanding First Pass Metabolism&quot; Retrieved 30/04,
  369. (2006). Urine as a biological specimen for forensic analysis of alcohol and variability in the urine-to-blood relationship.
  370. (2003). Urine drug testing for opioids, cocaine, and metabolites by direct injection liquid chromatography/tandem mass spectrometry.
  371. (2003). Urine testing for cocaine abuse: metabolic and excretion patterns following different routes of administration and methods for detection of false-negative results.
  372. (2003). Urine/blood ratios of ethanol in deaths attributed to acute alcohol poisoning and chronic alcoholism.
  373. (2003). Use of morphine and 6-monoacetylmorphine in blood for the evaluation of possible risk factors for sudden death in 192 heroin users.
  374. (2004). Validation of the Cozart microplate EIA for cocaine and metabolites in oral fluid.
  375. (2004). Value of hair analysis in postmortem toxicology.
  376. (1995). Vitreous alcohol. Forensic Sci Int 73: 157-58; author reply
  377. (1995). Vitreous humor cocaine and metabolite concentrations: do postmortem specimens reflect blood levels at the time of death?.
  378. (1990). Vitreous humor in the evaluation of postmortem blood ethanol concentrations.

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.