Old Poison, New Problem: Cyanide Fatal Intoxications Associated with Internet Shopping

Abstract

Widespread access to the Internet has an increasing influence on how suicides are committed. On websites such as eBay® or Amazon.com® highly toxic substances including cyanides are available for purchase. In the last 5 years, a few fatal intoxications associated with Internet shopping and buying “suicide kits” have been reported. Epidemiology of intoxications reported by American Association of Poison Control Centers between 2000-2018 shows that about 10% of all exposures to cyanide were related to suicide attempts and intentional ingestion of this substance. In order to determine the cyanide concentration in four fatal intoxication cases associated with Internet shopping, a headspace gas chromatography with dual column/dual flame ionization detector (HS-GC-FID/FID) method was validated and applied to casework. The method was linear in range, from 1 to 50 µg/mL, with a coefficient of determination of 0.999 (R2). The limit of quantification was 1.0 µg/mL; the detection limit was 0.5 µg/mL. Intra- and inter-day validation precision and accuracy did not exceed 10% and 15%, respectively. Recovery and matrix effect values ranged from 94.8– 103.8% and -5.2─3.8%, respectively. The cyanide concentrations were determined in biological fluids (blood, urine, bile, vitreous humor, gastric content) and postmortem tissue samples (spleen, kidney, liver, brain). The headspace gas chromatographic method, which is routinely used in clinical and forensic toxicology to quantify ethanol with its congeners (methanol, acetone, isopropanol, n-propanol and n-butanol), can be also applied to determine cyanide in intoxication cases. The global problem of a high number of suicides each year, requires increasing and more restrictive control of highly toxic substances available online as well as caution monitoring of human exposure to cyanide. This old and well known poison is being increasingly used nowadays for suicidal purposes, therefore determination of cyanide in biological samples is still important in terms of clinical and forensic toxicology.

The dark side of social media: Two deaths related with chloroform intoxication

“…This statistic emphasize that relatively easy access to chloroform enables using it in crime acts, even as crucial as the one described by Riβe et al [16] where a single father used chloroform in his children's voluntary manslaughter. Even though chloroform is not a common substance used nowadays, this back in the day used poison still can serve as a life threatening xenobiotic, together with other substances considered as old poisons, as there are reported cases related to for example, cyanide [13], arsenic [26], or sodium azide [27] poisoning. Epidemiology research conducted by Wachełko et al [28] indicate that the latter is more and more often used both in suicide and homicide attempts.…”

“…Decisively, less popular way that people choose to commit suicide is chloroform intoxication [10][11][12]. There have been cases [13][14][15] described in the literature that involved people committing suicide by using suicide kits purchased form the Internet. Chloroform, although being regarded to as an old, slightly forgotten poison, is still linked to homicide cases.…”

Nitrites: An Old Poison or a Current Hazard? Epidemiology of Intoxications Covering the Last 100 Years and Evaluation of Analytical Methods

“…In recent years, reports of fatal cases of toxic substances use for suicidal purposes have been rising worldwide, with the Internet contributing significantly to the prevalence. Unintentional fatalities after new psychoactive substances ingestion are well known nowadays [6][7][8][9][10], however, an increasing number of cases of suicide attempts using old, well-known drugs and poisons such as barbiturates [11][12][13][14], cyanide [15][16][17], chloroform [18,19], azide [20][21][22][23], and DMSO [24] (which were ordered online) are reported in the literature as well. The use of such substances is facilitated by the fact that such toxic substances can be easily purchased on websites such as eBay ® (https://www.ebay.com/, accessed on 2 August 2023) and Amazon ® (https://www.amazon.com/,accessed on 2 August 2023) [24][25][26].…”

Diagnosis of lethal cyanide poisoning. Analysis by Anion‐Exchange Chromatography with Pulsed Amperometric Detection

“…It is used as fumigant, rodenticide, in agricultural products [13] and in jewelry electroplating [14]. Cyanide is easily available on the website [15], especially in the so‐called “Deep Web” and “Dark Web” [16].…”