Hair testing of GHB: an everlasting issue in forensic toxicology

Busardò, Francesco Paolo; Pichini, Simona; Zaami, Simona; Pacifici, Roberta; Kintz, Pascal

doi:10.1515/cclm-2017-0397

Cited by 43 publications

(32 citation statements)

References 29 publications

(101 reference statements)

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Section: Hairmentioning

confidence: 99%

“…Owing to the dual nature of GHB, endogenous metabolite and recreational drug of abuse, major efforts have been exerted to establish endogenous concentrations in hair to serve as baseline levels [121]. Studies have shown that GHB concentrations in hair vary in relation to hair color and ethnicity and are usually in the range 0-5 ng/mg [121]. The first segment of hair closest to the scalp should not be used in the analysis of GHB, because of a possible contamination with sweat, which can elevate endogenous concentrations in hair up to 20 ng/mg hair [122].…”

Section: Hairmentioning

confidence: 99%

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Interpreting γ-hydroxybutyrate concentrations for clinical and forensic purposes

Busardò

Jones

2018

Clinical Toxicology

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Introduction: c-Hydroxybutyric acid is an endogenous substance, a therapeutic agent, and a recreational drug of abuse. This psychoactive substance acts as a depressant of the central nervous system and is commonly encountered in clinical and forensic practice, including impaired drivers, poisoned patients, and drug-related intoxication deaths. Objective: The aim of this review is to assist clinical and forensic practitioners with the interpretation of c-hydroxybutyric acid concentrations in blood, urine, and alternative biological specimens from living and deceased persons. Methods: The information sources used to prepare this review were PubMed, Scopus, and Web-of-Science. These databases were searched using keywords c-hydroxybutyrate (GHB), blood, urine, alternative specimens, non-conventional biological matrices, saliva, oral fluid, sweat, hair, vitreous humor (VH), brain, cerebrospinal fluid (CSF), dried blood spots (DBS), breast milk, and various combinations thereof. The resulting 4228 references were screened to exclude duplicates, which left 1980 articles for further consideration. These publications were carefully evaluated by taking into account the main aims of the review and 143 scientific papers were considered relevant. Analytical methods: The analytical methods used to determine c-hydroxybutyric acid in blood and other biological specimens make use of gas-or liquid-chromatography coupled to mass spectrometry. These hyphenated techniques are accurate, precise, and specific for their intended purposes and the lower limit of quantitation in blood and other specimens is 0.5 mg/L or less. Human pharmacokinetics: GHB is rapidly absorbed from the gut and distributes into the total body water compartment. Only a small fraction of the dose (1-2%) is excreted unchanged in the urine. The plasma elimination half-life of c-hydroxybutyric acid is short, being only about 0.5-0.9 h, which requires timely sampling of blood and other biological specimens for clinical and forensic analysis. Endogenous concentrations of GHB in blood: GHB is both an endogenous metabolite and a drug of abuse, which complicates interpretation of the laboratory results of analysis. Moreover, the concentrations of GHB in blood and other specimens tend to increase after sampling, especially in autopsy cases. This requires the use of practical "cut-off" concentrations to avoid reporting false positive results. These cutoffs are different for different biological specimen types. Concentrations of GHB in clinical and forensic practice: As a recreational drug GHB is predominantly used by young males (94%) with a mean age of 27.1 years. The mean (median) and range of concentrations in blood from apprehended drivers was 90 mg/L (82 mg/L) and 8-600 mg/L, respectively. The concentration distributions in blood taken from living and deceased persons overlapped, although the mean (median) and range of concentrations were higher in intoxication deaths; 640 mg/ L (280 mg/L) and 30-9200 mg/L, respectively. Analysis of GHB in alternative specimens: All bi...

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Section: Hairmentioning

confidence: 99%

Section: Hairmentioning

confidence: 99%

Interpreting γ-hydroxybutyrate concentrations for clinical and forensic purposes

Busardò

Jones

2018

Clinical Toxicology

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“…Physiological GHB concentrations were measured in all segments ranging between 0.2 and 0.7 ng/mg, which discards the involvement of this drug in this presumed DFSA, as recently shown by Busardo et al Five compounds – 4‐MEC, MDPV, doxylamine, tramadol, and mepivacaine – were found by LC–MS/MS. 4‐MEC, MDPV and doxylamine were detected in the first segment (A, 0–1 cm) at very low concentrations of 3, 5 m and 9 pg/mg, respectively (Figure ), while not being detected in the 2 following segments (Figure ).…”

Section: Resultsmentioning

confidence: 99%

Drug‐facilitated sexual assault (DFSA) involving 4‐methylethcathinone (4‐MEC), 3,4‐Methylenedioxypyrovalerone (MDPV), and doxylamine highlighted by hair analysis

Larabi

Martin

Etting

et al. 2018

Drug Testing and Analysis

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Recently, the emergence of new psychoactive substances (NPS) has led to their wide use among clubbers and men who have sex with men (MSM) for their stimulant effects. However, their use in drug-facilitated sexual assault (DFSA) has rarely been described. Herein we report a case of a 44-year-old man who was assaulted after a party. Due to late reporting of the offense, only hair (black) was sampled 15 days later and a segmental analysis was achieved to look for most DFSA agents and NPS. Twenty mg of each segment (A: 0-1 cm, B: 1-3 cm, and C: 3-5 cm) were incubated in phosphate buffer pH 5.0. After alkaline liquid extraction and chromatographic separation on 1.9 μm Hypersil GOLD PFP column, compounds were detected by a TSQ Vantage mass spectrometer with electrospray ionization in positive mode with multiple reaction monitoring (MRM) acquisition. 4-methylethcathinone (4-MEC), methylenedioxypyrovalerone (MDPV) and doxylamine were found in proximal segment at very low concentrations (3, 5, and 9 pg/mg, respectively) which is in agreement with a single exposure in the previous month corresponding to the alleged facts. These substances were not detected in segments B and C showing a lack of repetitive exposure before the alleged event. Thus, the results do not contradict the patient's claim of being assaulted. Doxylamine has already been encountered in such cases but no publications referring to 4-MEC or MDPV use have ever been documented. Our case reports the unusual administration of cathinones to achieve a sexual assault and stresses the interest of looking for designer drugs when dealing with DFSA cases.

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“…When she realizes the situation, it gets too late to investigate the drug used in crime from urine or blood (Dinis-Oliveira and Magalhães 2013; LeBeau and Montgomery 2010). Different drugs, e.g., ketamine, rohypnol, and GHB are used for the crime (Busardò et al 2018). Drugs used for DFSA are converted to metabolites, so their presence cannot be detected in urine or in blood.…”

Section: Applications Of Hair Analysis Drug-facilitated Sexual Assaultsmentioning

confidence: 99%

Forensic toxicological analysis of hair: a review

Usman¹,

Naseer²,

Baig³

et al. 2019

Egypt J Forensic Sci

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Analysis of hair provides useful information regarding drug addiction history or drug toxicity. Keeping in view some important applications of hair analysis, a lot of work done in the past few decades has been reviewed in this article. When compared with other biological samples, hair provides a larger window for drug detection. Drugs get deposited in hair through blood circulation by various mechanisms, after its administration. The deposited drug is much stable and can be detected after a longer period of time as compared with other biological samples, e.g., saliva, blood, and urine. Moreover, segmental analysis can depict multiple or single drug administration by using sensitive analytical techniques. Complex methods for drug extraction and the high cost of analysis are some drawbacks of hair analysis. LC-MS and GC-MS are the prominent among other techniques of choice due to high sensitivity. In this review, detailed knowledge about the drug deposition, extraction, analysis, and application of results in forensic and clinical cases have been discussed.

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Hair testing of GHB: an everlasting issue in forensic toxicology

Cited by 43 publications

References 29 publications

Interpreting γ-hydroxybutyrate concentrations for clinical and forensic purposes

Interpreting γ-hydroxybutyrate concentrations for clinical and forensic purposes

Drug‐facilitated sexual assault (DFSA) involving 4‐methylethcathinone (4‐MEC), 3,4‐Methylenedioxypyrovalerone (MDPV), and doxylamine highlighted by hair analysis

Forensic toxicological analysis of hair: a review

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