Drug-related death: adulterants from cocaine preparations in lung tissue and blood.
The abuse of drugs such as street cocaine is known to cause a variety of toxic effects, some of which involve the lungs and often induce lethal complications. While the toxicity of cocaine itself is reviewed well, the influence of toxic effects of its adulterants on the human body is not thoroughly studied. Therefore, we examined heart blood, femoral vein blood and lung tissue from 11 cases for typically used adulterants in cocaine preparations and check whether if the concentrations in the lung tissue are higher than in the blood. The adulterants were isolated using solid-phase (SPE) and liquid-liquid extraction (LLE) and quantified via high-pressure-liquid-chromatography-time-of-flight-mass spectrometry (LC/TOF-MS). Five adulterants, i.e., phenacetin, lidocaine, diltiazem, levamisole and hydroxyzine, were detected. We found out that the concentration of these substances was often higher in the lung than in the analogous analysed body fluids. It should therefore be considered whether - for the determination in the cause of death - the lung should be examined in addition to heart blood, urine or brain tissue.
Institute of Legal Medicine, University Hospital Duesseldorf, Moorenstraße 5, 40225 Duesseldorf, Germany. Electronic address: evelyn.pawlik@uni-duesseldorf.de.
Evelyn
E
Pawlik
State Bureau of Criminal Investigation NRW, Criminal Scientific and Technical Institute, Völklinger Straße 49, 40221 Duesseldorf, Germany. Electronic address: hellmut.mahler@polizei.nrw.de.
Hellmut
H
Mahler
Institute of Legal Medicine, University Hospital Duesseldorf, Moorenstraße 5, 40225 Duesseldorf, Germany. Electronic address: benno.hartung@med.uni-duesseldorf.de.
Benno
B
Hartung
State Bureau of Criminal Investigation NRW, Criminal Scientific and Technical Institute, Völklinger Straße 49, 40221 Duesseldorf, Germany. Electronic address: gerd.plaesser@polizei.nrw.de.
Gerd
G
Plässer
Institute of Legal Medicine, University Hospital Duesseldorf, Moorenstraße 5, 40225 Duesseldorf, Germany. Electronic address: fortoxi@uni-duesseldorf.de.
Thomas
T
Daldrup
D001774:Blood Chemical Analysis; D002851:Chromatography, High Pressure Liquid; D003042:Cocaine / Q000737:chemistry*; D019970:Cocaine-Related Disorders / Q000401:mortality; D004110:Diltiazem / Q000032:analysis; D004340:Drug Contamination; D053593:Forensic Toxicology; D006801:Humans; D006919:Hydroxyzine / Q000032:analysis; D013287:Illicit Drugs / Q000737:chemistry*; D007978:Levamisole / Q000032:analysis; D008012:Lidocaine / Q000032:analysis; D059625:Liquid-Liquid Extraction; D008168:Lung / Q000737:chemistry*; D013058:Mass Spectrometry / Q000379:methods; D009294:Narcotics / Q000737:chemistry*; D010615:Phenacetin / Q000032:analysis; D052616:Solid Phase Extraction
D013287:Illicit Drugs; D009294:Narcotics; D007978:Levamisole; D006919:Hydroxyzine; D008012:Lidocaine; D004110:Diltiazem; D010615:Phenacetin; D003042:Cocaine
Adulterants; Cocaine; Drug-related death; Lung tissue