Methamphetamine in hair and interpretation of forensic findings in a fatal case

doi:10.1016/j.forsciint.2005.04.037

Forensic Science International

Volume 153, Issue 1, 4 October 2005, Pages 93-97

https://doi.org/10.1016/j.forsciint.2005.04.037 Get rights and content

Abstract

Hair analysis for drugs has been developing and is considered a significant tool for distinguishing between recent and long-term drug abuse in forensic and clinical toxicology. Chronic consumption of drugs can gradually induce certain harmful effects on the human organism and can exacerbate some pre-existing diseases. Analysis for drugs in blood or urine in isolation does not provide sufficient information about the history of drug-use by a person and their results cannot be correlated directly with the toxic effects displayed. The chronic abuse of methamphetamine is known to be associated with cardiovascular diseases. During or after autopsy certain types of morphologic alterations are found in the hearts of stimulant addicts. The rapid increase in blood pressure after an intravenous methamphetamine dose can be risky for addicts with arteriosclerosis. However, the anamnestic data about a deceased person may not always be available to explain the pathological findings and to classify the cause of death correctly. The aim of this study was to demonstrate the value of hair analysis for drugs in the context of explaining pathological cardiovascular alterations observed during the autopsy in a case where methamphetamine consumption was involved. In this case, only methamphetamine and metabolites were detected with traces of ephedrine. Ephedrine is the precursor chemical in the illicit synthesis of methamphetamine (known in the Czech Republic as “Pervitin”). The femoral blood level of methamphetamine was 1500 ng/ml. It was documented by a witness that the 31-year-old man died within 1 h after an intravenous injection of the drug. The cause of death was established as cerebral edema due to cerebellar bleeding shortly after an intravenous dose of methamphetamine. Findings of methamphetamine in the first three 2-cm hair segments (numbered from the roots) were nearly equal (132 ± 9 ng/mg). In the fourth 2-cm segment, it was approximately one-half of previous values. In the remaining, distal 7-cm hair segment sample, the value of methamphetamine was higher and comparable to the third segment. These results provide clear evidence that the man had been a chronic methamphetamine abuser for more than 8 months. This information can help to explain the pathology, the consequence of which could be the bleeding into the cerebellum after the last single methamphetamine dose.

Introduction

Hair analyses for drugs are considered to be a significant tool in experienced hands for distinguishing between recent and long-term drug abuse, providing that some important and reasonable principles are understood [1], [2], [3], [4], [5], [6], [7], [8]. Attention must be paid to avoid external contamination of a hair sample and to avoid the surface transfer of a drug along the strand of the hair. Therefore, careful washing procedures of the hair's surface must be a part of the whole assay and the analytical findings in the wash solutions must be evaluated in relation to the analytical findings in the interior portion of the hair. Chronic consumption of drugs can gradually induce harmful effects and can exacerbate some pre-existing diseases [8], [9]. The analyses for drugs in blood or urine alone may not yield sufficient information about the drug-use history of a person, and the results cannot be correlated directly with the toxic effects displayed. The chronic abuse of methamphetamine is known to be associated with changes in the myocardium and results in cardiovascular diseases [9], [10], [11]. Certain types of morphologic alterations are found in the hearts of stimulant addicts during autopsy. The rapid increase of blood pressure after an intravenous methamphetamine dose can be risky for addicts with arteriosclerosis that has developed during chronic abuse. However, the anamnestic data about a deceased person may not always be available to explain the pathological findings and to correctly classify the cause of death. Hair analyses for drugs can be useful in this respect. The aim of this study was to demonstrate the value of hair analysis for drugs in the context of explaining observed changes to the myocardium and lungs during the autopsy of a subject in a case where methamphetamine had been consumed.

Section snippets

Case history

A 31-year-old male fell into coma after an intravenous dose of a drug and could not be resuscitated by medical emergency personnel. The medical rescue service arrived a few minutes after the call. The death occurred within 1 h after the drug administration. A friend of the deceased reported that they both had chronically consumed illicit methamphetamine called “Pervitin”, approximately three times a week. The last dose was reported to be intravenous and was shared between the friends. The friend

Chemicals

All chemicals and reagents were of analytical-grade purity. Reference standards used for calibration were methamphetamine hydrochloride (MA), amphetamine sulphate (AM), and ephedrine hydrochloride (EF). All were donated by UNODCP (Vienna, Austria). Norephedrine hydrochloride (NEF) was purchased from Fluka (Switzerland). Methamphetamine-D5-HCl (MA-D5) was purchased from Lipomed (Switzerland). Drug-free hair was provided by laboratory volunteers, and was verified to be blank through laboratory

GC–MS hair analysis—method validation results

Linearity of calibration was tested in the range of 0–200 ng/mg with acceptable results given in Fig. 1. Limits of detection (s/n > 3) were determined in ng/mg for the various analytes as follows—methamphetamine: 0.2, amphetamine: 4, and ephedrine: 0.1. Limits of quantitation were also determined in ng/mg and were 0.4 for methamphetamine, 10 for amphetamine and 0.4 for ephedrine. Repeatability was tested with spiked hair (n = 6) at 10 ng/mg with acceptable results as shown in Table 1. More favourable

Medical and toxicological results after autopsy of the case

The pathological alterations identified during autopsy in this case were:

(1)
Onset of heart hypertrophy (415 g).
(2)
Advanced heart myofibrosis, which was determined by histology (Fig. 2).
(3)
Thickening of coronary artery walls.
(4)
Remodelation of extracellular matrix in myocardium determined by immunohistochemical detection of MMP (matrixmetalloproteinase): significant activity of MMP 1 collagenase in intersticium of myocardium (Fig. 3). MMP2 and MMP9 were already weaker in this advanced stage of drug abuse.

Conclusion

The results of segmental hair analysis for amphetamines have provided clear evidence that the examined deceased person had been consuming methamphetamine for at least 8 months. This fact can help to explain the pathomorphological alterations in the myocardium and in the lungs found during autopsy. The increase in blood pressure after chronic abuse of methamphetamine can induce chronic hypertension that may cause arteriosclerosis associated with arterial weakness. In a chronic methamphetamine

Acknowledgement

This presentation is a part of a study generously supported by the grant MSM 111100005.

References (12)

R. Wennig
Potentional problems with the interpretation of hair analysis results
Forensic Sci. Int.
(2000)
M. Pujadas et al.
Development and validation of a gas chromatography–mass spectrometry assay for hair analysis of amphetamine, methamphetamine and methylenedioxy derivatives
J. Chromatogr. B
(2003)
Y. Nakahara et al.
Hair analysis for drugs o abuse. XIV. Identification of substances causing acute poisoning using hair root. I. Methamphetamime
Forensic Sci. Int.
(1997)
J. Röhrich et al.
Determination of amphetamine and methylendioxy-amphetamine-derivatives in hair
Forensic Sci. Int.
(1997)
F. Sporkert et al.
Determination of cathinone, cathine, and norephedrine in hair of Yemenite khat chewers
Forensic Sci. Int.
(2003)
M.N. Islam et al.
Cardiac lesions and their reversibility after long term administration of methamphetamine
Forensic Sci. Int.
(1995)

There are more references available in the full text version of this article.

Cited by (28)

Analysis of cosmetic residues on a single human hair by ATR FT-IR microspectroscopy
2018, Spectrochimica Acta - Part A: Molecular and Biomolecular Spectroscopy
In this work, ATR FT-IR spectra of single human hair and cosmetic residues on hair surface are successfully collected using a homemade dome-shaped Ge μIRE accessary installed on an infrared microscope. By collecting ATR spectra of hairs from the same person, the spectral patterns are identical and superimposed while different spectral features are observed from ATR spectra of hairs collected from different persons. The spectral differences depend on individual hair characteristics, chemical treatments, and cosmetics on hair surface. The “Contact-and-Collect” technique that transfers remarkable materials on the hair surface to the tip of the Ge μIRE enables an identification of cosmetics on a single hair. Moreover, the differences between un-split and split hairs are also studied in this report. These highly specific spectral features can be employed for unique identification or for differentiation of hairs based on the molecular structures of hairs and cosmetics on hairs.
Sample preparation methods for determination of drugs of abuse in hair samples: A review
2015, Analytica Chimica Acta
Citation Excerpt :
Amphetamines (aliquots of 10–200 mg of hair) are mainly extracted with HCl 0.1 or 1 M before an LLE [67,104] or SPE [49,91,94,103]. The analytical technique may vary from GC–MS [49,91,94,103,104] to LC-MS/MS [60,80,127]. For the determination of cocaine [45,48,52,91,94,97,99,103,126], opiates [45,49,52,103] and methadone [91,94,128], a similar extraction procedure used for amphetamines is employed, but the cleanup is conducted by SPE followed by a GC–MS analysis in most of the reported cases.
Hair analysis has assumed increasing importance in the determination of substances of abuse, both in clinical and forensic toxicology investigations. Hair analysis offers particular advantages over other biological matrices (blood and urine), including a larger window of detection, ease of collection and sample stability.
In the present work, an overview of sample preparation techniques for the determination of substances of abuse in hair is provided, specifically regarding the principal steps in hair sample treatment-decontamination, extraction and purification.
For this purpose, a survey of publications found in the MEDLINE database from 2000 to date was conducted. The most widely consumed substances of abuse and psychotropic drugs were considered.
Trends in simplification of hair sample preparation, washing procedures and cleanup methods are discussed. Alternative sample extraction techniques, such as head-space solid phase microextraction (HS-SPDE), supercritical fluid extraction (SFE) and molecularly imprinted polymers (MIP) are also reported.
Development and validation of a single LC-MS/MS assay following SPE for simultaneous hair analysis of amphetamines, opiates, cocaine and metabolites
2014, Forensic Science International
The two major challenges in hair analysis are the limited amount of samples usually available and the low targeted concentrations. To overcome these limitations, a liquid chromatography–electrospray-tandem mass spectrometry method (LC–ESI-MS/MS) allowing the simultaneous analysis of 17 amphetamines (amphetamine, BDB, m-CPP, dexfenfluramine, DOB, DOM, ephedrine, MBDB, MDA, MDEA, MDMA, methamphetamine, methylphenidate, 4-MTA, norephedrine, norfenfluramine and PMA), 5 opiates (morphine, codeine, heroin, ethylmorphine, and 6AM), cocaine and 5 metabolites [ecgonine methyl ester (EME), benzoylecgonine (BZE), anhydroecgonine methyl ester (AME), cocaethylene, and norcocaine] has been developed. The validation procedure included linearity, intra-day and inter-day variability and accuracy for 5 days (5 replicates at 3 concentration levels). Proficiency studies were used to check the accuracy of the method.
As a result, all amphetamines, opiates and cocaine derivatives were satisfactory identified by 2 MRM transitions in 15 min. Calibration curves were performed by a quadratic 1/X weighted regression. The calibration model fits from 0.05 to 10 ng/mg. The limits of detection (LODs) range between 0.005 and 0.030 ng/mg. Precision has been checked by intra-day and inter-day RSD, and associated relative bias, which were lower than 25% for the limits of quantifications (LOQs) and lower than 20% for the other levels tested. This method was routinely applied to hair samples: two positive results of adult drug addicts are presented.
Simple segmental hair analysis for α-pyrrolidinophenone-type designer drugs by MonoSpin extraction for evaluation of abuse history
2013, Journal of Chromatography B: Analytical Technologies in the Biomedical and Life Sciences
For detection of a history of drug abused, we developed a simple method for extracting pyrrolidinophenone-type designer drugs in human hair by using a MonoSpin^® C₁₈ column. Target drugs were extracted from a single alkaline-digested hair segment (length, 10 mm; weight, ca 0.1 mg). The analytes extracted were then analyzed by high-performance liquid chromatography–mass spectrometry without evaporation of the eluent after MonoSpin extraction. Linearity from 0.5 to 500 ng/mg was observed for all the tested drugs using an internal standard method (correlation coefficients >0.998) and the limit of detection was 0.2 ng/mg. The recoveries were between 0.7 and 11.1%. The coefficients for intraday and interday variations at 4, 40, 200, and 400 ng/mg in hair were between 0.7 and 11.1%. This method was successfully applied to the identification of these designer drugs in segmented human hair from drug abusers and indicated their history of drug abuse. The results were consistent with the patients’ statements, indicating that this rapid method can be used to detect a history of drug abuse.
Incorporation of methamphetamine and amphetamine in human hair following controlled oral methamphetamine administration
2012, Analytica Chimica Acta
Although hair testing is well established for the assessment of past drug exposure, uncertainties persist about mechanisms of drug incorporation into hair and interpretation of results. The aim of this study was to administer methamphetamine (MAMP) under controlled conditions as a model drug to investigate drug incorporation into human hair.
Seven volunteers with a history of stimulant use received 4 × 10 mg (low) doses of sustained release S-(+)-MAMP HCl within 1 week, with weekly head hair samples collected by shaving. 3 weeks later, 4 of them received 4 × 20 mg (high) doses. After extensive isopropanol/phosphate buffer washing of the hair, MAMP and its metabolite amphetamine (AMP) concentrations were determined in all weekly hair samples by LC–MS–MS in selected reaction monitoring mode with the undeca- and deca-deuterated drugs, respectively, as internal standards (LLOQ, 0.005 ng mg⁻¹).
MAMP T_max occurred from 1 to 2 weeks after both doses, with C_max ranging from 0.6 to 3.5 ng mg⁻¹ after the low and 1.2 to 5.3 ng mg⁻¹ after the high MAMP doses. AMP C_max in hair was 0.1–0.3 ng mg⁻¹ and 0.2–0.5 ng mg⁻¹, respectively, for low and high doses. Highly dose-related concentrations within subjects, but large variability between subjects were observed. MAMP concentrations were above the 0.2 ng mg⁻¹ cut-off for at least 2 weeks following administration of both low and high doses. The overall AMP/MAMP ratio ranged from 0.07 to 0.37 with a mean value of 0.15 ± 0.07, and a median of 0.13. The percentage of MAMP and AMP removed with the washing procedure decreased with time after administration. A strong correlation was found between area under the curve of MAMP (r² = 0.90, p = 0.00) and AMP (r² = 0.94, p = 0.00) concentrations calculated for the 3-week period following administration and the total melanin concentration in hair. Significant correlations were observed also between C_max and melanin.
This study demonstrated that despite large inter-individual differences, the incorporation of MAMP and AMP into hair is dose-related with much of the observed scatter of MAMP and AMP concentrations explained by melanin concentration in hair.
Methamphetamine: History, Pathophysiology, Adverse Health Effects, Current Trends, and Hazards Associated with the Clandestine Manufacture of Methamphetamine
2012, Disease-a-Month
Citation Excerpt :
Methamphetamine-induced agitation and hyperactivity can cause death secondary to metabolic acidosis and hyperthermia.204 Intracranial hemorrhage is a commonly reported neurological complication of methamphetamine abuse resulting in death.118 Methamphetamine-related status epilepticus may also contribute to death.202

View all citing articles on Scopus

View full text

Short communicationMethamphetamine in hair and interpretation of forensic findings in a fatal case

Abstract

Introduction

Section snippets

Case history

Chemicals

GC–MS hair analysis—method validation results

Medical and toxicological results after autopsy of the case

Conclusion

Acknowledgement

Forensic Sci. Int.

J. Chromatogr. B

Forensic Sci. Int.

Forensic Sci. Int.

Forensic Sci. Int.

Forensic Sci. Int.

Short communication
Methamphetamine in hair and interpretation of forensic findings in a fatal case