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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 25, Number 5, July/August, pp. 393-395
Alternate Strategies for Postmortem Drug Testing
Steven
B. Karch
Assistant Medical Examiner, City and County of San Francisco, San Francisco,
California
During the last decade, our ability to extract, and reliably quantitate,
drugs from blood and tissue has increased drastically. Yet in spite of these
advances, it is increasingly apparent that toxicologic measurements, taken in
isolation, cannot be used to discriminate between individuals who died as a
consequence of drug use and those who did not. The situation is not much better
in the living; it is still not possible to relate specific plasma drug concentrations
and impairment. Given that subnanogram drug quantitation is already possible,
further increases in measurement precision are unlikely to provide the answers
needed by pathologists, judges, and juries. Fortunately, the picture is not
so bleak as these observations would suggest. Alternate testing strategies employing
multiple tissue measurements may provide the needed answers.
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