1. Drug Identification and Toxicology
Pawson, PVMHS
2015

2. Student learning objectives:
By the end of this chapter you should be able to:
Identify the five types of controlled substances
Relate signs and symptoms of overdose with a specific class of drugs or toxins
Describe the role of various types of toxins in causing death
Discuss agents that may be used in bioterrorism
Define and describe the goals and practice of toxicology

3. Labs and activities: The Poisoner’s Handbook Botanical poisons
Movie
Online activity
Botanical poisons
Poisonous plants
Toxicology report
On a person of your choice who died due to drug overdose.
Munchausen syndrome by proxy case study
Jonestown

4. Forensic toxicology
Helps determine cause and effect relationships between:
Exposure to a drug or substance and…
Toxic or lethal effects from that exposure
People can be exposed to toxic substances:
Intentionally: by treating illness or relieving pain
Accidentally: by harmful combinations or overdoses
Deliberately: by harming or killing others, or by suicide

5. Types of Poisoning
Homicidal poisoning accounts for less than 1% of all homicides
Accidental drug overdoses are most common
8,500 per year due to heroin
24,000 per year due to prescription drugs
Botanical poisoning & accidental poisoning (household products) – usually children under 6
Drug offenders
Make up more than 50% of the federal prison population
Make up about 20% of the population in state prisons
Food poisoning – 3,000 Americans die each year

6. Drugs

7. Controlled Substances
Hallucinogens
Narcotics
Stimulants
Anabolic steroids
Depressants

8. Hallucinogens Often derived from plants
The effect and intensity of response to these drugs varies from person to person.
Affects the user’s perceptions, thinking, self-awareness, and emotions
Affects of an overdose often include
Increased heart rate
Increased blood pressure
Panic attacks, anxiety, or psychosis

9. Hallucinogens

10. Narcotics
Any psychoactive medicine with sleep-inducing, numbing properties.
Used in medicine for pain relief.
Medicines are habit forming.
Vicodin, Lortab, Percocet, OxyContin
Heroine, codeine, morphine
Derived primarily from opium poppy plants, also from mandrake root.

11. Narcotics

12. Stimulants Increases feelings of energy and alertness
Suppresses appetite
Afterwards, depression often results
Overdose affects include high blood pressure, agitation, confusion, seizures
Stimulants tend to be highly addictive

13. Stimulants

14. Anabolic Steroids A chemical structure similar to testosterone
Promote cell and tissue growth increasing bone mass and body muscle.
Popular with weightlifters, bodybuilders, and other athletes
What are some of the negative side effects?
Testicular atrophy, block normal sex hormones disrupting homeostasis, increase aggressive behavior, acne, high-blood pressure, liver disease, stunted bone growth (teens)

15. Depressants
Affects the central nervous system by increasing GABA activity, a neurotransmitter
Increased GABA causes drowsiness and slowed brain activity
Relieves anxiety and produces sleep
Side effects include slurred speech and loss of coordination
Mixing depressants with alcohol and other drugs increases potency and health risks
Ex: alcohol, barbiturates (fioricet, phenobarb), benzodiazepines (xanax, valium)

16. Alcohol Most commonly abused drug.
Kills more teens than all other drugs combined.
6% of college students are alcohol dependent.
In what way are alcohols toxic?
What is the effect of alcohol on the central nervous system?
What can chronic alcohol abuse cause?
Disrupts cell membranes, affecting the ability of your body cells to function. Causes dehydration.
Has to be metabolized by the liver and can only be done at a certain rate because enzymes are involved.
Blackout, memory loss, blurred vision, slow reaction time, difficulty walking
Esophageal cancer, liver cancer, cirrhosis of the liver, arrhythmias, high blood pressure, stroke, pancreatitis

17. Toxins

18. Bacterial toxins Tetanus Botulism Causes Lockjaw
Produced by the Clostridium tetani bacteria
Causes violent muscle spasms
Botulism
Produced by Clostridium botulinum—botulism
Paralyzes muscles
Causes irreversible damage to nerve endings
Extremely deadly in very small amounts
Most poisonous biological substance
BOTOX

19. Bacterial toxins Anthrax Bioterrorism agent
Bacillus anthracis, which forms endospores
Spreads to humans from infected animals
Enters the human body through:
Inhalation; causing breathing problems that usually result in death
Ingestion; becoming fatal in 25% to 60% of cases
Absorption via the skin; leading to death in about 20% of untreated cases
Is commonly used as a bioterrorism agent

20. Pesticides and heavy metals

21. Pesticides and heavy metals
Arsenic
Chemical element AS, atomic number 33
Highly toxic, disrupts ATP production
Lead
Chemical element Pb, atomic number 82
Used in building materials, batteries, bullets and shot
Accumulates in the soft tissues and bone
Damages nervous system, causes brain disorders
Why are children tested for lead levels in their blood?
Mercury
Chemical element Hg, atomic number 80
Used in thermometers, barometers, fluorescent lights, mercury switches, tooth fillings, cosmetics
Damages nervous system, can cause sensory impairment and lack of coordination.

22. Botanical toxins Ricin A poisonous protein in the castor bean
Lethal in extremely small amounts
Enters the body in various ways:
inhaled as a mist or a powder
ingested as food or drink
injected into the body
Causes death within a few hours
Is commonly used as a bioterrorism agent

23. Botanical toxins Cyanide Strychnine
Seeds of apples, apricots, cherries, and peaches
Also produced by certain bacteria, fungi, and algae
Chemical formula: CN−
Strychnine
From the strychnine tree (Strychnos nux-vomica)
Over the counter herbal supplements called Nux Vomica, are essentially small doses of strychnine!
Chemical formula: C21H22N2O2

24. Botanical toxins

25. Poisonous plants

26. Poisonous plants

27. Poisonous mushrooms

28. The Poisoner’s Handbook
Video
Library

29. Forensic toxicology

30. Celebrity overdose project
Library time to research a celebrity who has died of a drug overdose or alcoholism.
Photo
Name of celebrity, dates of birth/death
What they were known for
How they died
What were some aspects of their lifestyle that contributed to their death?
Did they suffer from any mental illness?

31. Drug testing
Analysis of a biological specimen for the presence of a specific drug or toxin
Urine, blood, breath, hair, sweat, saliva
If a police officer suspects you’re under the influence, they can order a drug test.
A positive drug test may lead to bail not being granted
If you are admitted to the hospital and suspected to be under the influence, a drug test will be ordered.
An employer may require a drug test before hiring.

32. Drug testing Alcohol – 12-24 hours in blood, 6-24 hours in urine.
Meth – 1-3 days in blood, 3-5 days in urine
MDMA – 3-4 days in blood and alcohol
Barbiturates – 1-2 days in blood, 1 day in urine
Benzo – 6 to 48 hours in blood, 4-6 weeks in urine (chronic use)
Cannabis – 2-3 days in blood (2 weeks in heavy users), days in urine (30 days in heavy users)
The only thing that really works and is undetectable is time & abstinence

33. DUI & DWI
0.08% or higher―Drivers 21 years old or older operating regular passenger vehicles.
0.04% or higher―Drivers operating commercial vehicles.
0.02% or higher―Drivers younger than 21 years old.
It's illegal to operate a motor vehicle with an open container of alcohol anywhere in the vehicle, no matter who's holding it. This means you can't drive with an empty liquor bottle in your backseat, nor have a passenger drinking a can of beer.

34. Munchausen syndrome by proxy
Munchausen syndrome by proxy is a mental illness and a form of child abuse. The caretaker of a child, either makes up fake symptoms or causes real symptoms to make it look like the child is sick. Many times, these symptoms appear due to deliberate poisoning by the caretaker.
Case studies:

35. Jonestown
A total of 909 Americans died in Jonestown, all but two from apparent cyanide poisoning, in an event termed "revolutionary suicide”
Video:
Was it suicide or homicide?