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Medico-legal assessment of methamphetamine and amphetamine serum concentrations—what can we learn from survived intoxications?

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Abstract

Medico-legal experts are increasingly enlisted to assess the methamphetamine and amphetamine serum concentrations after a criminal offense. However, since criminal users rarely provide useful information to medico-legal experts regarding the substances abused, when the substance(s) was/were used, dose of ingestion tools are needed to interpret the analytical data, which can be used as objective evidence in such cases. A comparative series of methamphetamine and amphetamine serum concentrations were used to analyze the frequency of concentrations, to determine methamphetamine/amphetamine concentration ratios, and prove them as a tool to distinguish pure methamphetamine from mixed amphetamine/methamphetamine ingestion. Additionally, two cases of survived accidental methamphetamine intoxication, resulting from ingestion smuggling which was longitudinally monitored, and pharmacokinetic parameters were assessed. In a series of 628 samples where the most frequent concentration of methamphetamine exceeded the therapeutic level, there was a strong correlation suggesting pure methamphetamine consumption, when the ratios of methamphetamine/amphetamine concentrations were within the range between 3 and 10. In the two cases of methamphetamine bodypacking, the relevant serum concentrations of methamphetamine and amphetamine, which could be measured up to 9 days after ingestion, indicated a decrease of the methamphetamine/amphetamine ratios in an exponential manner. However, the ratios were not always within the range between 3 and 10. Lastly, the course of the serum concentrations suggested an increase of the apparent elimination half-life of methamphetamine. In terms of the objective evidence required in criminal law, calculating methamphetamine/amphetamine concentration ratio is not a suitable to means to distinguish pure methamphetamine intake and that of mixed amphetamine/methamphetamine abuse in an individual case. Instead, methamphetamine high serum concentrations and the possible increase in apparent elimination half-life suggest that an extended detection period may be used to distinguish between “illicit use” as compared to “therapeutic use” of methamphetamine.

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Acknowledgements

The authors thank Karen Bluemke-Anbau for the helpful discussions, Dagmar Rumpelt and Kerstin Fehse for their excellent technical assistance, and Wolfgang Weissflog as well as Stan Patti for checking the spelling and grammar in this manuscript.

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Authors and Affiliations

  1. Institute of Legal Medicine, University of Halle-Wittenberg, Franzosenweg 1, D-06112, Halle, Germany

    Marco Weber, Rüdiger Lessig, Carolin Richter, Axel P. Ritter & Ilona Weiß

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  1. Marco Weber
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  2. Rüdiger Lessig
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  3. Carolin Richter
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  4. Axel P. Ritter
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  5. Ilona Weiß
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Correspondence to Marco Weber.

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Weber, M., Lessig, R., Richter, C. et al. Medico-legal assessment of methamphetamine and amphetamine serum concentrations—what can we learn from survived intoxications?. Int J Legal Med 131, 1253–1260 (2017). https://doi.org/10.1007/s00414-017-1607-5

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  • DOI: https://doi.org/10.1007/s00414-017-1607-5

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