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Postmortem distribution and redistribution of synthetic cathinones

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Abstract

Purpose

Synthetic cathinones are powerful psychostimulants that have been associated with fatal intoxications. Because of changes that take place following death, postmortem toxicology results require careful interpretation. The purpose of this study was to evaluate the distribution of synthetic cathinones in postmortem specimens in a series of 50 cathinone-positive fatalities.

Methods

Liquid chromatography–quadrupole time-of-flight-mass spectrometry was used to quantitatively identify cathinones in central blood (n = 51), peripheral blood (n = 31), urine (n = 33), liver (n = 22), vitreous humor (n = 1) and stomach contents (n = 1). The distribution of cathinones and the potential for postmortem redistribution was assessed.

Results

Among the 50 cases investigated, a total of nine synthetic cathinones (α-PVP, ethylone, methylone, butylone, MDPV, methedrone, pentylone, 4-MEC, and MDPBP) were identified in 139 specimens. The number of specimens per case ranged from one to six. In cases that included central blood or liver, together with a peripheral blood source, the central/peripheral (C/P) or liver/peripheral (L/P) ratio was calculated to estimate the potential for postmortem redistribution (n = 21 C/P; n = 11 L/P). Methylone and ethylone appeared to exhibit the greatest potential for postmortem redistribution, producing C/P ratios of 4.0 (1.5–6.1) and 2.9 (0.5–9.2), respectively. In contrast, the C/P ratio for α-PVP was 1.1 (0.5–1.9). Differences in C/P ratios between methylone and α-PVP were statistically significant (α = 0.05).

Conclusions

Although synthetic cathinones may exhibit low to moderate postmortem redistribution, significant variability exists due to site- and time-dependent factors. This, in combination with their overall instability, necessitates careful interpretation of postmortem toxicology results.

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Acknowledgements

This project was supported by Award No. 2013-R2-CX-K006 awarded by the National Institute of Justice, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect those of the Department of Justice.

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Authors and Affiliations

  1. Department of Forensic Science, Sam Houston State University, 1003 Bowers Blvd, Huntsville, TX, 77340, USA

    Lindsay Glicksberg & Sarah Kerrigan

  2. Dallas County Southwestern Institute of Forensic Sciences, 2355 North Stemmons Freeway, Dallas, TX, 75207, USA

    Lindsay Glicksberg

  3. Office of the Chief Medical Examiner, North Carolina Department of Health and Human Services, 4312 District Drive, Raleigh, NC, 27699, USA

    Ruth Winecker

  4. Los Angeles County Department of Medical Examiner-Coroner, 1104 N. Mission Road, Los Angeles, CA, 90033, USA

    Caitlin Miller

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  1. Lindsay Glicksberg
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  2. Ruth Winecker
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  3. Caitlin Miller
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  4. Sarah Kerrigan
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Correspondence to Sarah Kerrigan.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures involving biological samples obtained from human decedents were in accordance with the ethical standards of the Sam Houston State University Institutional Review Board (Protection of Human Subjects Committee) in accordance with 45CFR46.101(b) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Glicksberg, L., Winecker, R., Miller, C. et al. Postmortem distribution and redistribution of synthetic cathinones. Forensic Toxicol 36, 291–303 (2018). https://doi.org/10.1007/s11419-018-0403-3

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  • DOI: https://doi.org/10.1007/s11419-018-0403-3

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