Published: Journal of Analytical Toxicology, Volume 23, Number 1, January/February 1999, pp.69-70.

Methamphetamine—A Study of Postmortem Redistribution
F.E. Barnhart, J.R. Fogacci, and D.W. Reed

To the Editor:
San Diego County is commonly referred to as “The Methamphetamine Capital of the World”. Our laboratory encounters hundreds of cases involving methamphetamine annually. We studied the process of postmortem redistribution as it relates to methamphetamine. All analyses were performed using liquid–liquid isolation, derivatization, and detection by gas chromatography–mass spectrometry (GC–MS). As part of the study, we selected 20 cases at random and analyzed peripheral as well as central heart blood. In addition, we also analyzed heart tissue in five cases. In all cases, the central heart blood was higher than the peripheral blood. In the five cases where heart tissue was also analyzed, its value closely approximated that of the central blood. This phenomenon correlates with the cardiotoxic aspects of methamphetamine. The results suggest that interpretation of methamphetamine levels in either cause of death or behavioral modification requires the toxicologist to analyze peripheral blood samples.

Several authors have published material relating to the phenomenon of postmortem drug redistribution. Pounder and Jones (1) studied tricyclic antidepressants, barbiturates, and certain benzodiazepines. Pohland and Bernhard (2) published valuable information regarding the redistribution of fluoxetine. Logan and Smirnow (3) presented information indicating that redistribution occurs for the opiate morphine. As indicated by Baselt and Cravey (4), methamphetamine can produce behavioral changes and also be cardiotoxic. When death is directly attributed to methamphetamine intoxication, it is generally due to hypertension and a resulting arrhythmia. With that knowledge in hand, our laboratory decided to conduct a study to determine if the phenomenon of postmortem redistribution occurred with methamphetamine.

Peripheral blood samples were obtained from the femoral vein. Central blood was taken from the heart. Random heart tissue was obtained in certain cases.

Cases were selected at random with no preference given to type of death. One-gram samples were used. Methamphetamine (and amphetamine) was isolated from the biological samples using a liquid–liquid solvent extraction. Derivatization was achieved by using pentafluorpropionic anhydride (PFPA). Deuterium-labeled internal standards were used. Identification and quantitation were performed with GC–MS. Ions monitored are shown in Table I.

In the cases studied, the mode of death was mixed. Homicide, accidental, and suicide-type deaths were involved. The range of time between death and autopsy varied from approximately 12–36 h. Table II illustrates the concentrations of amphetamine and methamphetamine observed in central and peripheral blood samples. In addition, five cases have heart muscle determinations.

The peripheral blood samples were lower than central blood samples in all cases studied. This was true for both amphetamine and methamphetamine, although more pronounced in the latter. In the five cases studied, the myocardial tissue samples were higher than either peripheral or central bloods. It is apparent that methamphetamine diffusion takes place between the heart muscle and the blood within the chambers after death. Interpretation as to cause of death and/or modification of behavior depends on knowing the concentration in circulating blood. Although the cardiotoxic aspects of methamphetamine may be due to the affinity of heart muscle for methamphetamine, it is the amount that is circulating through the brain that affects behavior. Therefore, in conclusion, peripheral blood samples probably more accurately reflect the concentration of methamphetamine in circulating blood at the time of death. If death is delayed, even for a short time, and antemortem samples are obtained, they should be analyzed and values considered appropriately.

F.E. Barnhart, J.R. Fogacci, and D.W. Reed
San Diego County Medical Examiner’s Office
5555 Overland Avenue
San Diego, California 92123References

1. D.J. Pounder and G.R. Jones, Post-mortem drug redistribution–A toxicological nightmare. Forensic Sci. Int. 45: 253–263 (1990).
2. R.C. Pohland and N.R. Bernhard, Postmortem serum and tissue redistribution of fluoxetine and norfluoxetine in dogs following oral
   administration of fluoxetine hydrochloride (Prozac). J. Forensic Sci. 42(5): 812–816 (1997).
3. B.K. Logan and D. Smirnow. Postmortem distribution and redistribution of morphine in man. J. Forensic Sci. 42(2): 221–229 (1997).
4. R.C. Baselt and R.H. Cravey. Disposition of Toxic Drugs and Chemicals in Man, 4th ed. Chemical Toxicology Institute, Foster City, CA, 1995, pp 475–478.

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