Forensic Toxicology

, Volume 36, Issue 2, pp 291–303 | Cite as

Postmortem distribution and redistribution of synthetic cathinones

  • Lindsay Glicksberg
  • Ruth Winecker
  • Caitlin Miller
  • Sarah Kerrigan
Original Article



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.


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.


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).


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.


Synthetic cathinones Postmortem redistribution Methylone Ethylone LC–Q-TOF-MS 



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.

Compliance with ethical standards

Conflict of interest

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.


  1. 1.
    Cook DS, Braithwaite RA, Hale KA (2000) Estimating antemortem drug concentrations from postmortem blood samples: the influence of postmortem redistribution. J Clin Pathol 53:282–285CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Pounder DJ, Jones GR (1990) Post-mortem drug redistribution—a toxicological nightmare. Forensic Sci Int 45:253–263CrossRefPubMedGoogle Scholar
  3. 3.
    Jones GR, Pounder DJ (1987) Site dependence of drug concentrations in postmortem blood—a case study. J Anal Toxicol 11:186–190CrossRefPubMedGoogle Scholar
  4. 4.
    McIntyre IM, Hamm CE, Sherrard JL, Gary RD, Burton CG, Mena O (2015) Acute 3,4-methylenedioxy-N-ethylcathinone (ethylone) intoxication and related fatality: a case report with postmortem concentrations. J Anal Toxicol 39:225–228CrossRefPubMedGoogle Scholar
  5. 5.
    Dinis-Oliveira RJ, Carvalho F, Duarte JA, Remião F, Marques A, Santos A, Magalhães T (2010) Collection of biological samples in forensic toxicology. Toxicol Mech Methods 20:363–414CrossRefPubMedGoogle Scholar
  6. 6.
    Drummer OH (2004) Postmortem toxicology of drugs of abuse. Forensic Sci Int 142:101–113CrossRefPubMedGoogle Scholar
  7. 7.
    Barnhart FE, Fogacci JR, Reed DW (1999) Methamphetamine—a study of postmortem redistribution. J Anal Toxicol 23:69–70CrossRefPubMedGoogle Scholar
  8. 8.
    Pélissier-Alicot A-L, Gaulier J-M, Champsaur P, Marquet P (2003) Mechanisms underlying postmortem redistribution of drugs: a review. J Anal Toxicol 27:533–544CrossRefPubMedGoogle Scholar
  9. 9.
    Skopp G (2010) Postmortem toxicology. Forensic Sci Med Pathol 6:314–325CrossRefPubMedGoogle Scholar
  10. 10.
    Baselt RC (2017) Disposition of toxic drugs and chemicals in man, 11th edn. Biomedical Publications, Seal BeachGoogle Scholar
  11. 11.
    Logan B, Weiss E, Harruff R (1996) Case report: distribution of methamphetamine in a massive fatal ingestion. J Forensic Sci 41:322–323PubMedGoogle Scholar
  12. 12.
    McIntyre I, Hamm C, Bader E (2011) Postmortem methamphetamine distribution. J Forensic Res 2:1–3CrossRefGoogle Scholar
  13. 13.
    Elliott SP (2005) MDMA and MDA concentrations in antemortem and postmortem specimens in fatalities following hospital admission. J Anal Toxicol 29:296–300CrossRefPubMedGoogle Scholar
  14. 14.
    Dams R, De Letter EA, Mortier KA, Cordonnier JA, Lambert WE, Piette MHA, Van Calenbergh S, De Leenheer AP (2003) Fatality due to combined use of the designer drugs MDMA and PMA: a distribution study. J Anal Toxicol 27:318–323CrossRefPubMedGoogle Scholar
  15. 15.
    Rohrig TP, Prouty RW (1992) Tissue distribution of methylenedioxymethamphetamine. J Anal Toxicol 16:52–53CrossRefPubMedGoogle Scholar
  16. 16.
    De Letter EA, Bouche M-PLA, Van Bocxlaer JF, Lambert WE, Piette MHA (2004) Interpretation of a 3,4-methylenedioxymethamphetamine (MDMA) blood level: discussion by means of a distribution study in two fatalities. Forensic Sci Int 141:85–90CrossRefPubMedGoogle Scholar
  17. 17.
    De Letter EA, Clauwaert KM, Lambert WE, Van Bocxlaer JF, De Leenheer AP, Piette MHA (2002) Distribution study of 3,4-methylenedioxymethamphetamine and 3,4-methylenedioxyamphetamine in a fatal overdose. J Anal Toxicol 26:113–118CrossRefPubMedGoogle Scholar
  18. 18.
    Kennedy MC (2010) Post-mortem drug concentrations. Intern Med J 40:183–187CrossRefPubMedGoogle Scholar
  19. 19.
    Zhou M-J, Bouazzaoui S, Jones LE, Goodrich P, Bell SEJ, Sheldrake GN, Horton PN, Coles SJ, Fletcher NC (2015) Isolation and structural determination of non-racemic tertiary cathinone derivatives. Org Biomol Chem 13:9629–9636CrossRefPubMedGoogle Scholar
  20. 20.
    Gibbons S, Zloh M (2010) An analysis of the ‘legal high’ mephedrone. Bioorg Med Chem Lett 20:4135–4139CrossRefPubMedGoogle Scholar
  21. 21.
    Rojek S, Kłys M, Strona M, Maciów M, Kula K (2012) “Legal highs”—toxicity in the clinical and medico-legal aspect as exemplified by suicide with bk-MBDB administration. Forensic Sci Int 222:e1–e6CrossRefPubMedGoogle Scholar
  22. 22.
    Marinetti LJ, Antonides HM (2013) Analysis of synthetic cathinones commonly found in bath salts in human performance and postmortem toxicology: method development, drug distribution and interpretation of results. J Anal Toxicol 37:135–146CrossRefPubMedGoogle Scholar
  23. 23.
    Kesha K, Boggs CL, Ripple MG, Allan CH, Levine B, Jufer-Phipps R, Doyon S, Chi P, Fowler DR (2013) Methylenedioxypyrovalerone (“bath salts”), related death: case report and review of the literature. J Forensic Sci 58:1654–1659CrossRefPubMedGoogle Scholar
  24. 24.
    Shimomura ET, Briones AJ, Warren WS, Addison JW, Knittel JL, Shoemaker SA, King TD, Bosy TZ (2016) Case report of methylone, oxymorphone and ethanol in a fatality case with tissue distribution. J Anal Toxicol 40:543–545CrossRefPubMedGoogle Scholar
  25. 25.
    Pearson JM, Hargraves TL, Hair LS, Massucci CJ, Frazee CC, Garg U, Pietak BR (2012) Three fatal intoxications due to methylone. J Anal Toxicol 36:444–451CrossRefPubMedGoogle Scholar
  26. 26.
    Cawrse BM, Levine B, Jufer RA, Fowler DR, Vorce SP, Dickson AJ, Holler JM (2012) Distribution of methylone in four postmortem cases. J Anal Toxicol 36:434–439CrossRefPubMedGoogle Scholar
  27. 27.
    Barrios L, Grison-Hernando H, Boels D, Bouquie R, Monteil-Ganiere C, Clement R (2016) Death following ingestion of methylone. Int J Legal Med 130:381–385CrossRefPubMedGoogle Scholar
  28. 28.
    Potocka-Banaś B, Janus T, Majdanik S, Banaś T, Dembińska T, Borowiak K (2017) Fatal intoxication with α-PVP, a synthetic cathinone derivative. J Forensic Sci 62:553–556CrossRefPubMedGoogle Scholar
  29. 29.
    Hasegawa K, Suzuki O, Wurita A, Minakata K, Yamagishi I, Nozawa H, Gonmori K, Watanabe K (2014) Postmortem distribution of α-pyrrolidinovalerophenone and its metabolite in body fluids and solid tissues in a fatal poisoning case measured by LC-MS-MS with the standard addition method. Forensic Toxicol 32:225–234CrossRefGoogle Scholar
  30. 30.
    Wyman JF, Lavins ES, Engelhart D, Armstrong EJ, Snell KD, Boggs PD, Taylor SM, Norris RN, Miller FP (2013) Postmortem tissue distribution of MDPV following lethal intoxication by “bath salts”. J Anal Toxicol 37:182–185CrossRefPubMedGoogle Scholar
  31. 31.
    McIntyre IM, Hamm CE, Aldridge L, Nelson CL (2013) Acute methylone intoxication in an accidental drowning—a case report. Forensic Sci Int 231:e1–e3CrossRefPubMedGoogle Scholar
  32. 32.
    Sykutera M, Cychowska M, Bloch-Boguslawska E (2015) A fatal case of pentedrone and α-pyrrolidinovalerophenone poisoning. J Anal Toxicol 39:324–329CrossRefPubMedGoogle Scholar
  33. 33.
    McIntyre IM (2014) Liver and peripheral blood concentration ratio (L/P) as a marker of postmortem drug redistribution: a literature review. Forensic Sci Med Pathol 10:91–96CrossRefPubMedGoogle Scholar
  34. 34.
    Glicksberg L, Bryand K, Kerrigan S (2016) Identification and quantification of synthetic cathinones in blood and urine using liquid chromatography-quadrupole/time of flight (LC-Q/TOF) mass spectrometry. J Chromatogr B 1035:91–103CrossRefGoogle Scholar
  35. 35.
    Scientific Working Group for Forensic Toxicology (SWGTOX) (2013) Standard practices for method validation in forensic toxicology. J Anal Toxicol 37:452–474CrossRefGoogle Scholar
  36. 36.
    Adamowicz P, Tokarczyk B, Stanaszek R, Slopianka M (2013) Fatal mephedrone intoxication—a case report. J Anal Toxicol 37:37–42CrossRefPubMedGoogle Scholar
  37. 37.
    Dalpe-Scott M, Degouffe M, Garbutt D, Drost M (1995) A comparison of drug concentrations in postmortem cardiac and peripheral blood in 320 cases. Can Soc Forensic Sci J 28:113–121CrossRefGoogle Scholar
  38. 38.
    Roettger JR (1990) The importance of blood collection site for the determination of basic drugs: a case with fluoxetine and diphenhydramine overdose. J Anal Toxicol 14:191–192CrossRefPubMedGoogle Scholar
  39. 39.
    Moriya F, Hashimoto Y (1999) Redistribution of basic drugs into cardiac blood from surrounding tissues during early stages postmortem. J Forensic Sci 44:10–16PubMedGoogle Scholar
  40. 40.
    Glicksberg L, Kerrigan S (2017) Synthetic cathinone stability in blood. J Anal Toxicol 41:711–719CrossRefPubMedGoogle Scholar
  41. 41.
    Glicksberg L, Kerrigan S (2017) Stability of synthetic cathinones in urine. J Anal Toxicol. PubMedCrossRefGoogle Scholar
  42. 42.
    Fura A, Harper TW, Zhang H, Fung L, Shyu WC (2003) Shift in pH of biological fluids during storage and processing: effect on bioanalysis. J Pharm Biomed Anal 32:513–522CrossRefPubMedGoogle Scholar
  43. 43.
    Cook JD, Strauss KA, Caplan YH, LoDico CP, Bush DM (2007) Urine pH: the effects of time and temperature after collection. J Anal Toxicol 31:486–496CrossRefPubMedGoogle Scholar
  44. 44.
    Ferner RE (2008) Post-mortem clinical pharmacology. Br J Clin Pharmacol 66:430–443CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Japanese Association of Forensic Toxicology and Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Forensic ScienceSam Houston State UniversityHuntsvilleUSA
  2. 2.Dallas County Southwestern Institute of Forensic SciencesDallasUSA
  3. 3.Office of the Chief Medical ExaminerNorth Carolina Department of Health and Human ServicesRaleighUSA
  4. 4.Los Angeles County Department of Medical Examiner-CoronerLos AngelesUSA

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