Children victims of drug abuser parents: Hair testing as a forensic tool to assess exposure-A cohort of 37 cases from Spain.

Hair testing is a useful tool to investigate suspected pediatric exposure to drugs of abuse. Newborns and young children are at high risk of exposure to drugs of abuse from parents or caregivers who consumed these substances, a fact prosecuted by Spanish authorities as child abuse. A retrospective study based on a cohort of 37 cases classified using several parameters, which involve children under 12 years old, were analyzed at the Drugs Laboratory of the National Institute of Toxicology and Forensic Sciences (Madrid, Spain) between 2009 and 2021. Hair samples were tested for the presence of opiates, cocaine, ketamine, amphetamines, methadone, and cannabis using a gas chromatography-mass spectrometry (GC-MS) method. A 59% of the studied children had ages in the range of 1-3 years old, and in 81% of cases, victims required hospitalization. In 81% of cases (n = 30), hair was submitted only or in combination with other samples, and these were classified in four categories according to analyzed samples: A (only hair), B (hair and blood), C (hair and urine), and D (hair, blood, and urine). The 93.3% of these cases (n = 28) showed a positive result of cannabinoids (THC and CBN in hair and THC-COOH in urine; 71.4% n = 20), cocaine and metabolites (benzoylecgonine and cocaethylene; 46.4% n = 13), opiates (morphine and 6-acetylmorphine), and amphetamines (MDMA and MDMA; 3.10% n = 1). Hair analysis matched positive results in cases where urine screening test was carried out previously (n = 24) and in those cases where blood and/or urine were also submitted (35.6% n = 11). As a conclusion, hair analysis was confirmed as a useful tool to detect previous exposure to acute poisoning events in children.

Intoxicación suicida por nitrito sódico: una peligrosa modalidad en Internet. A propósito de un caso / Suicidal poisoning by sodium nitrite: A dangerous mode from Internet. In regard of a case

Se reporta un caso de suicidio por ingesta de nitritos. Se trata de una joven que fue hallada muerta en un vehículo junto a una serie de objetos, entre ellos una bolsa de polvo blanco etiquetada como «nitrito sódico» y comprimidos de lorazepam, paracetamol y metoclopramida. La autopsia reveló signos compatibles con metahemoglobinemia. Se remitieron muestras de sangre, humor vítreo y contenido gástrico, así como la bolsa con el polvo, los comprimidos y otros objetos al Servicio de Drogas del Departamento de Madrid del Instituto Nacional de Toxicología y Ciencias Forenses. El polvo fue identificado como nitrito sódico, y se detectaron concentraciones de nitritos en las muestras biológicas similares a las de otras intoxicaciones letales. El porcentaje de metahemoglobina en sangre fue del 80%. La existencia de páginas en Internet donde el suicidio con nitritos y metoclopramida es detalladamente descrito, así como el aumento del reporte de este tipo de suicidios, alertan acerca de una posible tendencia. (AU)

A case of suicide by nitrites ingestion is reported: a young woman was found death into a car with various objetcs around her, such as a white powder bag labelled as «sodium nitrite» and pills of lorazepam, acetaminophen and metoclopramide. The autopsy revealed signs compatible with methemoglobinemia and samples of blood, vitreous and gastric content were submitted to the Drugs Service of the National Institute of Toxicology and Forensic Sciences in Madrid, as well as the powder bag, the pills and other objects. The white powder was identified as sodium nitrite, and nitrites concentrations similar to other fatalities were detected in biological samples. The methemoglobin level was 80%. The existence of websites where suicide with nitrites and metoclopramide is described step-by-step, joined to the increasement of reports about these fatalities, alert us to a possible trend. (AU)

Intoxicación letal por opio por el consumo de ejemplares silvestres de Papaver somniferum / Fatal intoxication by opium from wild specimens of Papaver somniferum

Se reporta un caso de muerte por consumo de opio y se destaca la contribución de la toxicología forense en el esclarecimiento de la misma. La víctima fue un varón de 20 años quien tras recoger cápsulas de adormidera (Papaver somniferum L) pertenecientes a ejemplares que crecían de manera silvestre en un campo de la provincia de Toledo, y consumir el contenido de las mismas, falleció al día siguiente tras presentar dificultades respiratorias. La autopsia reveló pulmones edematosos, y las muestras de sangre y humor vítreo fueron remitidas al Servicio de Drogas del Instituto Nacional de Toxicología y Ciencias Forenses en Madrid, así como un fragmento de la sustancia vegetal que resultó resina de hachís. Alcaloides del opio (morfina, codeína, noscapina y tebaína), anfetaminas y cannabinoides fueron hallados en los análisis químico-toxicológicos. Se dictaminó que fue una muerte violenta de etiología accidental por policonsumo de drogas, con un rol preponderante del consumo de opio. (AU)

A new fatality due to opium consumption is reported here and the importance of Forensic Toxicology in clarifying this death is highlighted. The deceased was a 20-year-old male who, after collecting opium poppy capsules (Papaver somniferum L) which grew wild in a field near Toledo and consuming his latex (opium), died the next day after presenting respiratory difficulties. The Autopsy revealed congestive lungs and blood and vitreous humor samples were submitted to the Drugs service of the National Institute of Toxicology and Forensic Sciences in Madrid, as well as a piece of vegetal substance, which was identified as hashis. Cannabinoids, amphetamine and opium alkaloids (morphine, codeine, noscapine and tebaine) were found in the toxicologycal analysis. As conclusion, a violent death of accidental etiology due to mixed drug intoxication is here presented. In our opinion, the opium consumption had a preponderant toxic role in this fatality. (AU)

Sumisión química en casos de presuntos delitos contra la libertad sexual analizados en el Instituto Nacional de Toxicología y Ciencias Forenses (Departamento de Madrid) durante los años 2010, 2011 y 2012 / Alleged drug-facilitated sexual assault cases analyzed at the National Institute of Toxicology and Forensic Science (Madrid Department) during the years 2010, 2011 and 2012

Introducción. La sumisión química en relación con los delitos contra la libertad sexual se puede aplicar tanto a los casos de administración subrepticia de determinadas sustancias, como a los casos oportunistas por una mayor vulnerabilidad de la víctima debido al consumo voluntario de las mismas. Material y métodos. Se ha realizado un estudio descriptivo retrospectivo de los casos de agresiones sexuales relacionados con el consumo de sustancias químicas, remitidos durante los años 2010, 2011 y 2012 al Departamento de Madrid del Instituto Nacional de Toxicología y Ciencias Forenses. Se ha recogido información en relación con el perfil de la víctima, el tipo de muestras biológicas remitidas y los resultados toxicológicos. Resultados. De los 306 casos de agresión o abuso sexual remitidos, 107 han cumplido los criterios de inclusión. El perfil de la víctima es el de una mujer española o latinoamericana joven (edad media: 25,9 años), que admite consumo de alcohol previo al episodio, y que sufre de amnesia total o parcial de los hechos. Las muestras remitidas han sido sangre (27,1%), orina (14%) o ambas (57%). El análisis toxicológico ha sido positivo en el 87,9% de los casos, y las sustancias identificadas han sido etanol (61,7%), fármacos (40,2%, fundamentalmente benzodiacepinas) y drogas ilícitas (27,1%, fundamentalmente cocaína), solas o en combinación. Conclusiones. El estudio refleja la necesidad de trabajar en prevención e información de potenciales víctimas y personal sanitario, que una temprana y adecuada toma de muestras son factores claves a la hora de confirmar el diagnóstico, y que las sustancias detectadas, lícitas e ilícitas, pertenecen a un patrón de consumo frecuente en nuestra sociedad (AU)

Introduction. Drug-facilitated sexual assault crimes can be applied in cases of covert administration of certain substances, as well as cases in which the victim voluntarily consumes these same substances. Materials and methods. This study describes retrospectively cases of sexual assault related to the consumption of chemical substances. They were reported to the Madrid Department of the National Institute of Toxicology and Forensic Sciences during 2010, 2011 and 2012. We collected information related to the victim's profile, the type of biological samples given and the results of the toxicological analysis. Results. Out of 306 cases of sexual assault or abuse referred, 107 have met the inclusion criteria. The victim's profile is of a young Spanish or Latin-American woman (mean age: 25.9 years) who admits to consuming alcohol prior to the episode and suffering from total or partial amnesia with regard to the facts. The given samples were blood (27.1%), urine (14%) or both (57%). Toxicological analysis was positive in 87.9% of cases and the substances identified were ethanol (61.7%), pharmaceuticals (40.2%, mainly benzodiazepines), and illicit drugs (27.1%, primarily cocaine) either alone or in combination. Conclusions. This study reflects the requirement to work in prevention and training of potential victims and healthcare personnel, proves that an early and adequate collection of samples are key factors to confirm the diagnosis and identifies that detected licit or illicit substances belong to a frequent consumption pattern (AU)