Module 1 Overview - Forensic Toxicology

The sale and distribution of illegal drugs involves a global black market with an estimated retail value totalling more than US$ 320 billion. Law enforcement agencies have engaged in attempts to prevent the distribution and sale of illegal drugs since the growing problem was first recognized in the early 1960s.

Financial incentives drive the sale of illegal drugs: dealers want to get rich and be powerful. The result is often high levels of property crime, murder, and social disorder. Law enforcement agencies, therefore, work towards reducing the extent of the drug trade to prevent such crimes from becoming more frequent..

Each year, numerous injuries and deaths result from the use of illegal drugs. Forensic toxicology plays an important role in the investigation of such incidents and their related crimes.

The ingestion of a poison or toxin (usually by swallowing or injecting) can lead to life-threatening injuries and/or death. Ingestion may be accidental or deliberate, and it includes cases of suicide and murder. Accidental poisonings and suicidal acts stemming from the consumption of poisons and/or toxins are non-criminal matters. The deliberate poisoning of an individual or group of persons is a criminal matter that will typically result in a police investigation. The science of forensic toxicology has an important role in successfully investigating and prosecuting such crimes.

• Lesson 1 of this module examines the physiological effects of illegal drugs upon the human body. This lesson identifies some of the most common illegal drugs and describes the harmful side effects of drugs upon the human body. Also, this lesson explores the subject of drug-impaired driving.
• Lesson 2 describes various types of poisons and toxins and explains the physiological effects of poisons and toxins on the human body.
• Lesson 3 identifies and describes some of the toxicological tests used by forensic scientists.
• Lesson 4 examines the details of two historical crimes and one fictional crime that each relate to forensic toxicology.

Module Learner Objectives

By the end of Module 1, you should be able to…

• appreciate that the field of forensic toxicology involves the identification of various types of drug(s) and/or poison(s) found within an individual’s system
• recognize that illegal drugs have harmful side-effects upon the human body
• review the harmful effects of various types of illegal psychoactive drugs upon the human body (e.g., opiates, marijuana, barbiturates, cocaine, amphetamines)
• recognize that the illegal drug trade has a direct relationship upon other crimes and that it causes social disorder
• discuss the dangers of driving a motor vehicle while under the influence of drugs and the need for drug testing devices for police officers
• recognize that drugs, poisons, and toxins are extracted from the body using procedures that involve acid-base extraction
• understand the mechanics of various toxicology testing procedures used to screen for drugs or poisons (e.g., color testing, microcrystalline testing, immunoassay testing, gas chromatography)
• explain how the toxicological testing technique of mass spectrometry is used to confirm the presence of specific drugs or poisons within the human body
• identify various types of poisons (e.g., cyanide, carbon monoxide, arsenic, strychnine) and their harmful side-effects upon the human body
• analyze historical crime cases and/or fictional crime cases that involves forensic toxicology

Defining Forensic Toxicology

Toxicology is the study of the origin, nature, and properties of various drugs, poisons, and toxins. Toxicological specialists work in hospitals where the identification of an overdose can mean life or death.

The terms drugs, poisons, and toxins have subtle and often overlapping definitions.

• Drugs are usually substances ingested intentionally to produce a change that results in better health, pain relief, or pleasure.
• Poisons are usually substances ingested unintentionally that cause poorer health. Most drugs can be taken at high doses to become poisons. One common method of attempting suicide is to take too many drugs or to ingest poison intentionally.
• Toxins are harmful environmental chemicals that cause negative health effects, usually after prolonged exposure. However, exposure to toxins at high concentrations can quickly cause harmful effects or even death. Intentionally exposing someone else to a toxin is a crime.

Forensic toxicology is the application of toxicology in the pursuit of solving criminal cases. It generally is concerned with the detection and identification of drugs, poisons, or toxins that cause adverse physiological effects. Law enforcement agencies and medical examiner's offices require the services of forensic toxicologists. The main responsibility of a forensic toxicologist is to detect and identify the presence of drugs, poisons, or toxins in body fluids, tissues, and organs.

The work of a forensic toxicologist is generally in three main categories:

1. Testing for alcohol in blood and/or urine samples
2. Detection of drugs, poisons, and toxins in body fluids, tissues, or organs
3. Identification and measurement of the specific type of drug, poison, or toxin found within a subject

How Drugs Affect the Human Body

Most illegal drugs are psychoactive drugs; that is, they alter a person’s perception or mood. Some psychoactive drugs are known as depressants because they reduce an individual’s sense of alertness by causing relaxation (e.g., marijuana). Other psychoactive drugs are known as stimulants because they intensify an individual’s sense of alertness to cause hyperactivity (e.g., cocaine).

Psychoactive drugs can be taken orally or through injection, but they may be absorbed through body membranes such as those located in the nose, lungs, rectum, or vagina. To influence the human body, any type of drug must be absorbed into the blood stream and be transported to the body region where it has an affect. Initially, a drug can be detected both in the region it targets and throughout the bloodstream.

Drugs that are taken orally go through a slightly different process. Any drug absorbed through the digestive tract into the bloodstream must first pass through the liver before it travels to the body region that it affects. As the drug passes through the liver, some of the drug is broken down into metabolites. The amount of drug that gets metabolized depends upon a number of factors including the polarity and stability of the drug, the rate of absorption of the drug and the form of the drug ingested (tablet, capsule, liquid, etc.). Rates of metabolism also differ from individual to individual as determined by genetics and other environmental factors. Almost always, the metabolites of the original drug will have a different effect on the body region it targets than the original form of the drug. Sometimes, metabolism renders a drug completely inactive and it passes harmlessly out of the body but in other cases, the metabolite might be just as active as the original drug although it may target a slightly different body region or use a different pathway to achieve its effect. It is also possible for the original drug to be ingested in an inactive form that must be metabolized by the liver before it becomes active and has any effect on the body region that it targets. The effects of orally ingested drugs usually have a delayed onset when compared to other methods of drug delivery because of the additional time required for the drug to pass through the digestive tract, be absorbed by the blood stream, and metabolized by the liver.

Pathway #1

drugs taken → digestive → blood → liver → body region → liver → kidneys → excreted
   orally              tract           stream                they affect            

Drugs that are injected or are absorbed through body membranes pass immediately into the blood stream and travel directly to the body region they affect. Then, as the blood continues to circulate through the body, the drugs will pass through the liver and begin to be metabolized.

Pathway #2

drugs injected
or absorbed through → blood stream → body region → liver → kidneys → excreted
body membranes                                    they affect

Once the drug travels to the region of the body that it affects, it may also be broken down by that organ or system. Every time the blood circulates through the body, more and more of the drug is broken down by the liver and is eventually transported to the kidneys and excreted into the urine. The overall length of time that it takes the body to completely metabolize a drug into an inactive metabolite determines how long an individual will experience an effect from that drug. Therefore, forensic toxicologists may look for a drug or the breakdown products of a drug in three areas:

• the blood
• the urine
• the target region

Metabolism of a drug happens over time. As a result, depending on which metabolite they are testing for, forensic toxicologists can detect the presence of a drug or one of its metabolites, hours, days, weeks and months after the drug was originally taken. Rohypnol, the date rape drug, can now be tested for in urine up to 8 days after the original dose was taken where as cocaine can be tested for in hair up to 3-6 months after it has been used.

Most psychoactive drugs target the cells of the central nervous system (CNS), which consists of the brain and the spinal cord. Psychoactive drugs tend to alter the activity between the cells of the CNS known as neurons. More specifically, psychoactive drugs change or mimic the actions of the neurotransmitters released by the neurons. When stimulated, neurotransmitters are released by a neuron, and they move from that neuron through a space (called the synapse) towards a receptor neuron. When neurotransmitters come into contact with the receptor neuron, responses are triggered. After a neurotransmitter has triggered a receptor neuron, it is broken down quickly so it no longer produces an effect. Examples of responses that may be triggered by receptor neurons within the CNS are muscle and heart contractions, increased or slowed heart rate, the sensation of pain, the interpretation of visual images, emotions, and sleep.

Many psychoactive drugs exist; some are legal and others are illegal. Forensic toxicologists analyze psychoactive drugs that are most often illegal. Illegal psychoactive drugs are of several types, each having its unique effects upon the body. Two general categories of psychoactive drugs are depressants and stimulants.

Depressants

Depressants (also called narcotics) are psychoactive drugs that cause drowsiness, sleep, and insensibility. Many depressants prevent the release of neurotransmitters. This stops neuron stimulation, which produces feelings of relaxation. Other depressants mimic neurotransmitters that prevent the feeling of pain and cause a dull, relaxed state of mind. Most depressants are available only through prescriptions from medical doctors. However, one of the most powerful and addictive of all depressants is alcohol—and it is legal. The three most common types of illegal depressants are the opiates, marijuana, and the barbiturates.

Stimulants

Stimulants are psychoactive drugs that increase alertness and metabolism, cause hyperactivity, stimulate sexual arousal, and repress hunger. Some stimulants prevent the breakdown of neurotransmitters causing neurons to fire continuously. Other stimulants mimic the effects of neurotransmitters, resulting in an increase of neural stimulation in the CNS. Most stimulants are available only through prescriptions from medical doctors. The two most common types of illegal stimulants are cocaine and amphetamines.

Conventional wisdom suggests that drug addiction leads to higher rates of property crime as an indirect result of the overwhelming desire for drugs. The motivation driving the drug trade often results in competition among those who choose to sell illegal drugs, often producing violent incidents ranging from simple assaults to drive-by shootings.

Specific examples of the relationship between illegal drug use and other crimes include high rates of property crime and petty theft, social disorder related to open-air drug markets, and an increase in murder rates when competing criminal gangs engage in “turf wars” to protect drug distribution networks.

The use of marijuana and heroin increased in North America during the latter half of the 1960s during which time crime rates increased dramatically.  The early 1980s were characterized by the increasing popularity of cocaine, the importation of which led to gang warfare and localized crime and disorder in large cities. These social effects were further magnified by an increase in the use of ‘crack’ cocaine, which is several times more addictive than other forms of cocaine. Annual drug-related arrests have more than tripled since the 1970s.

Drug-Impaired Driving - A Deadly Mix

A Drug-Impaired Driving Tragedy

On the night of June 27, 1999, four vehicles carrying fourteen teenaged friends returning from an end-of-the-school-year party were involved in a multi-vehicle crash just outside Perth, Ontario. One of the four vehicles, driven by a 17-year-old male under the influence of marijuana, pulled into the oncoming lane to pass on a straight stretch of highway. It struck a pick-up truck towing a trailer with a car inside.  The collision caused a multi-vehicle collision that killed five of the teenagers in the four cars and seriously injured the two occupants of the pick-up truck.

Detecting Drugs in a Driver

Perhaps surprisingly, motor vehicle collisions caused by drug-impaired drivers are thought to occur just as frequently as those caused by alcohol-impaired drivers. Detecting signs of drug impairment during traffic stops is much more complicated than detecting drivers impaired by alcohol. No roadside-screening device can quickly and accurately assist police officers to determine impairment by drugs.  By comparison, alcohol impairment is relatively easy to detect with standard roadside testing procedures.

Although saliva and sweat can be tested for the presence of drugs, the highest concentration of the by-products of drug breakdown is contained in blood and urine. As a result, blood and urine are the most reliable body fluids to be analyzed. However, Canada has not yet enacted legislation to provide law enforcement officers with the authority to demand and seize such samples in cases of drug-impaired driving. In some Canadian jurisdictions, police officers are trained to seek voluntary tests from persons suspected of drug-impaired driving during impaired driving investigations. Law enforcement agencies in the United States benefit from “implied consent laws” that compel drivers to submit samples of their breath or blood in criminal investigations. In Canada, police officers currently rely on the cooperation of suspected drug-impaired drivers. Police are unable to continue investigating should the suspect decline to participate.  Canadian police officers, by law, cannot demand participation in drug-related field sobriety testing.

To get more drug-impaired drivers off the road, law enforcement agencies require accurate and portable roadside screening devices to test for drug impairment. The most common roadside drug screening devices are small hand-held single-use devices that are wiped in the mouth or on a suspect’s skin. The devices test saliva and/or sweat for the presence of cocaine, marijuana, opiates, and amphetamines. These devices do not indicate how much of the drug has been ingested by the suspect. To confirm the presence and determine the actual quantity of a drug(s) in a suspect, urine or blood samples must be analyzed by a forensic toxicologist. Canadian police agencies do not use roadside drug-screening devices because no legislation allows for this type of evidence to be used in court. Also, these roadside drug screening devices are not 100% accurate. Because false positive results can occur, a blood or urine analysis by a forensic toxicologist is the only certain test.

Possible Changes to Drug-Impaired Driving Laws

Since 1999, the Canadian Government has been studying ways in which provisions of the Criminal Code relating to the investigation of drug-impaired driving can be strengthened.

Currently, police officers who conduct drug-impaired driving investigations rely upon a suspect’s driving pattern, witness testimony, and informal methods of detecting signs of impairment exhibited by the suspect. Police officers do not have authority to make formal demands for urine or blood samples during drug-impaired driving investigations, except in very specific circumstances involving motor vehicle collisions involving injury to others. Only samples provided voluntarily by the accused can be presented as evidence in court.

In November 2006, the Government of Canada proposed to amend Canada’s Criminal Code for the purpose of stricter control on drug-impaired drivers.  Suggested changes could give police new powers to apprehend and test drivers suspected of drug impairment and increase penalties for such offences.

New laws proposed by the federal government would provide police with the authority to conduct the following procedures during drug-impaired driving investigations:

1. Standardized Field Sobriety Tests administered at the roadside when there is a reasonable suspicion that a driver has taken drugs

2. Drug Recognition Expert (DRE) evaluations used when a police officer believes a drug-impaired driving offence has been committed. (These evaluations would be administered at a police station and include examination of pupil size, observation of eye movement, standard sobriety tests, a physical examination including measurements of blood pressure and heart rate, and an interview with the suspect to gain additional information related to possible drug ingestion.)

3. A toxicological examination (i.e. sample of blood or urine) should the DRE officer identify that the impairment was caused by a certain class of drugs (The analysis of blood or urine is intended to support the findings of the initial DRE evaluation and would proceed only if reasonable grounds exists to make such a request.)

Refusal to comply with any of these demands would constitute a criminal offence, punishable in the same manner as refusing to comply with a demand for breath samples. Penalties for a first offence generally consist of a $600 fine and a brief licence suspension often concurrent with a suspension levied under provincial law. Second offences typically result in a higher monetary fine and possible jail time of up to 14 days. These penalties may increase if proposed amendments to federal legislation are passed in Parliament.

Related Case Study Questions

1. Can the Breathalyzer device or Intoxilyzer device detect drugs? If no, state why.
   Ans.  No, the Breathalyzer device or Intoxilyzer device cannot detect drugs. These devices test breath samples, but by-products of drug breakdown cannot be found in breath samples.
2. List four body fluids that contain the by-products of drug breakdown.
   Ans.  Blood, saliva, sweat, urine
3. What body fluids contain the highest concentration of the by-products of drug breakdown?
   Ans.  Blood and urine
4. Explain why the evidence obtained from a roadside drug-testing device cannot be used to convict a suspected drug-impaired driver?
   Ans.  Roadside drug-testing devices indicate only if a particular drug is present. They do not indicate the quantity of the drug(s) in the body. They do not provide consistently reliable results. Also, Canadian legislation does not all this evidence to be used in court.
5. What would the drug-impaired driving legislation allow police officers to demand from a suspected impaired driver?
   Ans. 

   The new laws would allow police to demand the following during drug-impaired driving investigations:

   • Standardized Field Sobriety Tests administered at the roadside when there is a reasonable suspicion that a driver has taken drugs
   • Drug Recognition Expert (DRE) evaluations when a police officer believes a drug-impaired driving offence was committed (This includes a situation where the driver fails the sobriety tests. These evaluations can be administered at a police station and can help police notice the signs and symptoms of drug-impairment in drivers and then testify against them.)
   • A sample of body fluid (i.e., blood or urine) should the DRE officer determine that evidence of  impairment was caused by a certain class of drugs

General Description of Poisons

Poisons are chemical compounds that can cause injury, illness, or death when sufficient quantities are absorbed. They cause damage by inhibiting normal chemical reactions occurring in the body. Poisons can cause harm through a single massive dose or after high levels accumulate over time. Poisons are most commonly absorbed through ingestion (eating) and inhalation (breathing).

Prompt treatment combats poisons. Treatments vary according to the specific type of poison absorbed. If a poisoning is not treated swiftly, permanent damage or death is possible. Organ damage caused by poisons is often repairable; however, when a poison targets the brain or spinal cord, damage is often permanent. Poisons that are ingested in large doses are usually identifiable by the distinct symptoms that each causes. Poisons that are administered more gradually or in smaller doses can be a problem to identify because their symptoms are initially very similar to a wide variety of diseases.

Toxins are poisonous compounds produced in living organisms (such as substances released by certain mushroom species or released by bacteria that cause tetanus or botulism). Even at very low concentrations, toxins can typically affect humans and often are detectable using only sensitive analytical instruments. Some toxins have antidotes and others do not. Animal toxins such as those from snakes, insects, or stingrays, are known as venoms and cause their effect through injection (sting or bite).

Examples of Venomous Animals: Snake and Stingray

Hundreds of poisons exist. Symptoms caused by some well-known poisons such as carbon monoxide, arsenic, cyanide, and strychnine are described below. Note that these are only a few of the existing poisons. Criminal investigations involving poisoning do not necessarily involve only these types of poisons.

Carbon monoxide is one of the most common poisons in accidental or suicidal poisoning cases. Carbon monoxide (CO) is produced from the incomplete combustion (burning) of carbon based fuels and may be released into living spaces by defective gas appliances (such as ovens, furnaces, and heaters). When CO is inhaled, it prevents oxygen from attaching to the hemoglobin molecules within red blood cells. When excessive amounts of CO are absorbed, an individual suffocates to death because oxygen cannot reach the cells of the body. An obvious symptom of CO poisoning is the bright red appearance of the skin and internal organs.

Carbon monoxide poisoning by hooking up a hose to the exhaust pipe of a car or running a car inside a closed garage used to be a common method of suicide. The amount of carbon monoxide produced in car exhaust is dependant on a number of factors but, since the development of catalytic converters, the percentage of carbon monoxide in car exhaust has been greatly reduced.

Richard Saferstein, Ph.D: Criminalistics—An Introduction to Forensic Science. New Jersey: Prentice-Hall, Inc., 1998. (p. 317)

The chart below identifies several additional common poisons and some of the symptoms caused by each.

- Source: Biocrawler website

The UN standard symbol for a poisonous substance is the Jolly Roger, or skull and crossbones. However, many companies consider this symbol negative for purposes of marketing. Therefore, in North America the symbol, Mr. Yuk (see below), is replacing the Jolly Roger. Companies argue that the skull and crossbones symbol may attract children because of its association with pirates, but Mr. Yuk does not.

- Source: The Brown Daily Herald

Paracelsus, the father of toxicology (1493-1541), said, "Everything is poison, there is poison in everything. Only the dose makes a thing not a poison". Deaths due to poisonings do not always involve the consumption of a true poison. Rather, they may also be caused by the accidental or intentional overdose of a substance that is not even considered poison (such as Aspirin®, alcohol, or household cleaners).

The actual number of poisonings in North America is unknown because not all cases of poisonings are detected or reported. Approximately 2 million cases are reported voluntarily to poison control centers each year. About 700 deaths by poisoning are reported in North America each year. Children less than 6 years of age account for the majority of reported poisonings, most of which are accidental ingestion of household cleaners. In contrast, adults account for the majority of deaths by poisoning, most of which are intentional suicides rather than accidental or intentional poisonings.

Notice in Charts A and B below that the type of poisons most frequently reported are not the same as the types of poisons most frequently causing death. The majority of reported poisonings (Chart A) are accidental overdoses that do not necessarily cause death. For example, a small child drinks some window cleaner left in his or her reach. Poisonings causing death (Chart B) are due to accidental overdoses or intentional suicides. Most suicides involve intentional overdoses of pain relievers (such as Aspirin® or Tylenol®), antidepressant drugs, or carbon monoxide. Other deaths due to poisons in Chart B are ordinarily the result of accidental overdoses.

Homicides due to intentional poisonings are rare. Estimates indicate only 1% or less of all homicides are the result of poisoning. Two possible reasons for this are

• the most potent and easy-to-disguise poisons are not readily available to the average consumer
• intentional poisonings take much planning and preparation because the killer requires some knowledge of the precise amounts necessary of specific poisons to cause death

The infamous Tylenol® murders occurred in 1982 when seven people in the Chicago area of the United States died after consuming Extra Strength Tylenol® capsules that had been laced with cyanide. This was the first known serial murder case caused by deliberate product tampering.

The Victims

On the morning of September 29, 1982, a 12-year old girl who had a headache died after taking a single capsule of Extra Strength Tylenol®. On that same day, an adult male who had also taken a capsule of Extra Strength Tylenol®, died in hospital. The next day, two members of the male victim’s family died, his brother and sister-in-law, after each taking a capsule from the same bottle. Between September 30 and October 1, 1982, three women all living separately but near Chicago died after taking capsules of Extra Strength Tylenol®.

The Police Investigation

After forensic toxicologists detected cyanide in each of the seven victims, they informed police investigators who soon discovered the Tylenol® link among the victims. Police then broadcast urgent warnings to the public through the media and by driving through Chicago neighbourhoods shouting warnings over loudspeakers.

Police determined that each of the five tampered Tylenol® bottles came from different factories. Therefore, the possibility of sabotage at the production stage in the factory was eliminated. Investigators supposed the culprit(s) had entered various stores in the Chicago area over several weeks and had tampered with bottles of Tylenol® by adding solid cyanide to some of the capsules within. The addition of the cyanide was likely done at another location because no witnesses ever claimed to have seen the tampering being done in any of the stores. After the culprit(s) added the poison to the capsules, he or she somehow put the capsules into the bottles, placing the full, sealed bottles on store shelves. Then, as usual, people bought them. After a massive product re-call of Extra Strength Tylenol®, three more tampered bottles were discovered at various stores in the Chicago area.

The Company’s Response

Extra Strength Tylenol® is a product of the company called Johnson & Johnson. When Johnson & Johnson was told of the poisonings of their product, it distributed warnings to hospitals and distributors, stopped all Tylenol® production, and suspended their advertising. Johnson & Johnson then issued a nationwide recall of all 31 million bottles of Tylenol® products.

After forensic investigators determined that only Tylenol® capsules were tampered with, Johnson & Johnson offered to exchange all capsules purchased with solid tablets. In addition, Johnson & Johnson offered a $100 000 reward for the capture and conviction of "the Tylenol Killer".

About the time of the killings, the price of Tylenol® stock collapsed from $35 to $8, but it rebounded in less than a year. Johnson & Johnson soon reintroduced Tylenol® capsules in a new, triple-sealed package. Within several years, Tylenol® again became the most popular over-the-counter pain medication in North America.

Related Arrests

James W. Lewis was arrested after he contacted Johnson & Johnson telling them that he would stop the murders after he was given a large sum of cash. Later, investigators determined that Lewis was not responsible for the tampering, and that he was simply trying to extort money. James W. Lewis served 13 years of a 20-year prison term for this extortion attempt.

Police investigated Roger Arnold for the Tylenol® murders, but he was cleared of the killings. However, the intense media attention caused Arnold to have a mental breakdown during which he tried to kill the man he thought was responsible for turning him into police. However, due to his confused mental state, Arnold killed a complete stranger. Roger Arnold was found guilty of second-degree murder and served 15 years of a 30-year prison sentence.

Conclusion

The Tylenol® serial murder case has never been solved, but the incident led to changes in the packaging of over-the-counter drugs and in federal anti-tampering laws in Canada and the United States. All over-the-counter drugs now require tamper-proof safety seals. Product tampering is a federal crime in both countries.

The Tylenol® murders also prompted drug companies to reduce the production of capsules because foreign substances such as poisons are easily placed inside capsules without obvious signs of tampering. Many drug companies have replaced capsules with solid tablets.

Related Crime Case Questions: The Tylenol® Murders

• State the type of poison added to the Extra Strength Tylenol® that killed seven people in the Chicago area in 1982.
  Ans.  Cyanide was added to the Extra Strength Tylenol® that killed seven people in the Chicago area in 1982.

• Describe how investigators think the killer added the poison to various bottles of Extra Strength Tylenol® in this case.
  Ans.  Investigators think that over several weeks the culprit entered various stores in the Chicago area, removed eight bottles of Extra Strength Tylenol®, added solid cyanide to some of the capsules in each bottle, and then placed the bottles back on store shelves. The addition of the cyanide was likely done at another location because no witnesses ever came forward saying they had seen the tampering occur.

• Why were police investigators able to rule out the possibility the poison was added to the Tylenol® capsules during their production?
  Ans.  Police determined that the tampered Tylenol® bottles came from different factories. Therefore, the possibility of sabotage at the production stage in each factory was considered unlikely.

• Describe specifically how the poison used in this case causes death in a victim.
  Ans.  Cyanide breaks down an important enzyme in the mitochondria of cells and prevents the production of ATP. Without the energy from ATP, body cells die. Cyanide tends to target cells in the brain, spinal cord, and heart – thus producing a quick death.

- Rudyard Kipling: Website

The Role of Toxicology in Forensic Investigations

Forensic toxicologists have the task of identifying which drugs, toxins, or poisons an individual involved in a criminal investigation has in his or her system. This is a huge undertaking because of the thousands of drugs and poisons. On some occasions, police investigators supply the victim’s symptoms, his or her personal effects, and empty drug containers to toxicologists to help them identify substances of interest.

Drug overdoses, alcoholic poisonings, and drug-impaired driving cases are the most common criminal cases involving forensic toxicology. However, forensic toxicologists are also involved in attempted homicide, homicide, and suspected suicide cases where intentional poisoning or drug overdose is suspected.

Blood is the most common substance analyzed to identify the drugs and determine their concentrations in a suspect or victim, living or dead. Hair, saliva, sweat, and urine may be examined. Other organs and tissues examined for drugs include bone, brain tissue, liver tissue, and stomach contents.

For a forensic toxicologist to determine the identity and quantity of drugs or poisons within an individual, the suspected substances must be extracted and isolated from the body fluid, organs, or tissues. There are several procedures used to isolate and extract drugs and poisons. Most of these involve the use of acids and bases.

An acid is any substance that releases hydrogen ions (H+) when dissolved in water. A base is any substance that accepts hydrogen ions (H+) when dissolved in water. Most drugs and poisons are either acids or bases. For example, most barbiturates have a pH below 7; therefore, they are acidic. Most amphetamines have a pH above 7 and, therefore, are basic.

During an acid-base extraction procedure, body fluids, tissues, or organs are placed in an acidic solution and/or a basic solution. Acidic drugs or poisons are easily extracted from an acidic solution; basic drugs or poisons are easily extracted from a basic solution.

After these acid-base procedures are completed, the drug or poison is identified as an isolated sample. The isolated sample(s) then goes through a screening test and, finally, through a confirmation test.

Initial Screening for Drugs or Poisons

After an isolated sample has been collected by a forensic toxicologist, it is then screened to identify any drugs or poisons such as alcohol, marijuana, or arsenic. Common toxicology screening techniques include colour testing, microcrystalline testing, immunoassay testing, and gas chromatography.

Colour Testing

Colour testing is a fast and simple technique used to determine if an individual has drug or poison in his or her system. This technique can identify the type of drug or poison present. However, colour tests exist for only certain substances, and they cannot indicate the quantity of the suspected substance. Because of this, colour testing is always followed by a confirmation test.

In one type of colour testing, a small test strip is dipped into a urine sample. The strip changes to a specific colour when exposed to a certain drug or poison. In another colour testing technique, certain chemicals are combined with an isolated sample. A reaction that causes a colour change indicates the presence of a certain drug or poison. In the Marquis colour test, an isolated sample is combined with formaldehyde and sulfuric acid. If the resulting solution turns purple, this indicates that the sample contains opiates.

Microcrystalline Testing

In this technique, a small amount of an isolated sample is combined with a specific chemical reagent. If a certain drug or poison is present, a chemical reaction occurs, producing a crystalline precipitate. The crystalline structure and colour vary according to the drug or poison being tested. After the precipitate has formed, it may be analyzed under a microscope to confirm its identity.

Microcrystalline testing can be more accurate than colour testing. However, like colour testing, it does not indicate the quantity of the suspected substance. Also, microcrystalline tests can test for only certain substances such as cocaine and methamphetamines. Because of this, microcrystalline testing is always followed by a confirmation test.

Immunoassay Testing

Immunoassay testing identifies and measures the level of a drug or poison in an isolated sample. It uses the chemical reactions of antibodies to their specific antigens. Immunoassay testing is common because it is able to detect and accurately determine the concentration of the drug or poison in an isolated sample.

Antibodies for drugs and poisons are produced in animal test subjects by combining the drug or poison with a protein to produce a drug-protein complex. Then, this is injected into the animal where it is perceived by the animal’s immune system as an antigen. Consequently, the animal’ immune systems produces specific antibodies against this complex. Then, these antibodies are collected from the blood of the animal and used in immunoassay testing.

For example, the breakdown-products of marijuana are combined with a protein and then injected into an animal test subject. Antibodies of this THC-complex are created and collected from the animal’s blood. These THC antibodies are then added to an isolated sample. If marijuana is in the sample, the THC antibodies react. If no marijuana is in the sample, the antibodies do not react. If THC antibodies do react, then estimating the number of THC antibodies that react determines the quantity of marijuana in the sample. To determine the quantity of antibodies that react, they must be labelled either with an enzyme (enzyme immunoassay technique, or EIT) or a radioactive isotope (radioimmunoassay, or RIA).

Some organic substances have similar chemical structures to certain drugs and poisons. As a result, these may react with the immunoassay antibodies to produce a false positive result. Because of this, immunoassay testing is always followed by a confirmation test.

Gas Chromatography

Gas chromatography separates an isolated drug or poison sample into its distinctive component chemical parts. Gas chromatography is common because it is accurate and fast. The basic steps involved in the gas chromatography technique include the following.

1. The isolated sample is placed in a heated injection chamber.
2. Small amounts of the isolated sample and some nitrogen gas are injected into narrow, coiled glass or stainless steel tubing that is 2 to 6 metres long. The inside of the tubing contains a thin film of liquid.
3. As the isolated sample passes through the tubing, its components are separated because they diffuse at different rates into the liquid.
4. By the time the isolated sample reaches the end of the tubing, its components are completely separated.
5. The individual components of the isolated sample enter a detector. This detector generates a series of electrical signals that produce a chromatogram.

A standard chromatogram is a graph with a series of peaks that correspond to the individual chemical components of a substance (see diagram below). Each drug or poison creates a predictable and distinctive peak or series of peaks that emerge at predictable times. Therefore, each can be identified easily in a chromatogram. The quantity of the individual drug or poison corresponds to the height of the peak(s) on the chromatogram. Thus, the higher the peak(s), the higher the concentration of drug or poison within the individual sample.

Example Chromatogram of Three Types of Barbituates

Because some organic substances have similar chemical structures to certain drugs and poisons, similar chromatograms may be produced by organic substances and the drugs. Therefore, false positive results are possible. Because of this, gas chromatography is always followed by confirmation testing as is immunoassay testing.

Both cocaine and marijuana can be detected in the bloodstream up to three days after a single dose has been ingested. Fact Sheet: Drug Testing in the Criminal Justice System. US Department of Justice: Drugs and Crime Data, March 1992.

Confirmation Testing for Drugs, Toxins, or Poisons

After the identification and possible quantification of a drug or poison is completed through a particular screening test, a confirmation test will either reinforce or refute these results. The most common device used by forensic toxicologists is the mass spectrometer.

In order to get a confirmation from mass spectrometer analysis, the drug of interest must first be isolated.  If the sample has already been analyzed using gas chromatography, the drug and/or its metabolites have already been separated from one another so it makes sense that gas chromatography and mass spectrometry are often used in conjunction with one another.  Once an isolated sample has been separated into its components by gas chromatography, those components are sent one by one into a mass spectrometer where they are analyzed individually.

Poisoning of an ex KGB agent

Alexander Litvinenko dying in hospital, November 20, 2006.

- Image courtesy of Reuters

Alexander Valterovich Litvinenko was an ex-KGB agent and ex-FSB lieutenant colonel. After working in those services for many years, he made accusations that his superiors had ordered the assassination of Russian billionaire Boris Berezovsky, who had close ties with former Russian President Boris Yeltsin. After these public accusations, Litvinenko was fired from the FSB in 1998 and arrested in 1999. He was charged with abusing his power while in command during a FSB anti-terrorism operation. After a month in prison, he was released. He signed an agreement that he would not leave Russia.

In 2000, Litvinenko illegally left Russia to visit Turkey where he met his wife and son. Later that same year, the Litvinenko family left Turkey for the United Kingdom where they claimed political asylum. In 2002 and 2003, he published two books in which he severely criticized Russian President Vladimir Putin and his government. In his first book, Litvinenko alleged that FSB agents were involved in a 1999 bombing of an apartment block that killed more than 300 people. Russian officials blamed the explosions on Chechen separatists. They confiscated over 4000 copies of Litvinenko’s first book in Moscow before they could be sold. In his second book, Litvinenko alleged that President Vladimir Putin, during his time at FSB, was personally involved in organized crime.

On November 1, 2006, after meeting with two former KGB agents, Litvinenko suddenly fell ill and was hospitalized. The report is that he met these agents to discuss details concerning the October 2006 killing of Anna Politkovskaya, a controversial Russian journalist who had written articles critical of President Vladimir Putin and his government.

Initial screening tests by forensic toxicologists suggested that Litvinenko was poisoned by radioactive thallium. Thallium was a common ingredient in rat poison, but its use was banned in the 1970s. Thallium is colourless, odourless, and water-soluble. Among the distinctive effects of thallium poisoning are hair loss and damage to peripheral nerves. However, confirmation testing of these results did not reinforce the screening test results that Litvinenko was poisoned with thallium.

On November 23, 2006, Alexander Litvinenko died in the London hospital where he was being treated. Forensic toxicologists from the Health Protection Agency in the United Kingdom established that Litvinenko died after being poisoned with the radioactive isotope polonium-210. The poison had either been eaten or inhaled by Litvinenko.

The radioactive isotope, polonium-210, does not naturally occur in significant quantities. Its only known source is artificial production in a specialized nuclear reactor. Polonium-210 is used in photographic anti-static brushes, as a heat source to power thermoelectric cells in manmade satellites, and as a heat source to prevent the internal parts of lunar vehicles from freezing.

The use of polonium-210 as a poison had never been documented officially before. When absorbed in humans, polonium-210 causes hair loss, nausea, spleen damage, and liver failure. Without a working spleen, the human body has difficulties fighting infection, but an individual can live without a spleen because the liver and lymphatic system compensate for its absence. However, if a person’s liver fails, he or she will die within 24 hours because the body is unable, among other things, to regulate blood sugar, to break down fats or old red blood cells, and to produce blood proteins.

Police investigators found traces of polonium-210 at Litvinenko’s home, at a London hotel that Litvinenko visited before he became ill, and at a sushi restaurant where he ate on November 1. Forensic scientists and police investigators traced the source of the polonium used to poison Litvinenko to a nuclear power plant in Russia. Then, in December 2006, police investigators found traces of polonium-210 on two British airplanes that had flown between London and Moscow. The announcement about the source of the polonium and the presence of polonium on the airplanes has lead many to suspect that the murder of Alexander Litvinenko was coordinated by an individual or a group of individuals in Russia. At time of writing, this criminal case remains unsolved.

In May 2007, British authorities formally requested the extradition of Andrei Lugovoi, an ex-KGB agent, to face murder charges in Britain with regard to Alexander Litvinenko's death. Both Lugovoi and the Russian government responded by denying any involvement.

Related Crime Case Study Questions: The Poisoning of a Russian Secret Service Ex-Agent

1. Explain one reason the initial screening of Litvinenko indicated that he had been poisoned with radioactive thallium rather than polonium-210.
   Ans.  A substance with a chemical composition similar to thallium may have been present in Litvinenko’s body and, therefore, produced a false positive test or a false positive peak in a chromatogram.
2. What specific poisoning symptom caused Alexander Litvinenko to die?
   

   Ans.  Liver failure. If a person’s liver fails, he or she will die within 24 hours because the body is unable to regulate blood sugar, to break down fats or old red blood cells, or to produce blood proteins. Because of a build-up of toxins, death results.

3. What is the likely source of the unusual poison used to kill Alexander Litvinenko likely?
   Ans.  A nuclear reactor in Russia

                                                    

Viktor Yushchenko
before his Dioxin poisoning in July 2004, and
after his Dioxin poisoning in November 2004.
- Source: Associated Press

Background

Viktor Yushchenko was an accountant and economist appointed head of Ukraine’s national bank in 1993, shortly after the country gained independence from the former Soviet Union. From 1999 -2001, Yushchenko became Prime Minister of the Ukraine. In 2004, he ran for the office of President.

On September 5, 2004, Viktor Yushchenko had dinner at the home of the head of Ukraine’s Security Service. The next day, he experienced severe abdominal pains and vomiting. After several days of no improvement and barely able to walk, Yushchenko was rushed to a medical clinic in Austria where doctors discovered that his liver, pancreas, and intestines were swollen and damaged. After several days in hospital in Austria, Yushchenko returned to the Ukraine to continue campaigning in the presidential election. During this campaign, Yushchenko used painkillers heavily to help him deal with his discomfort.

In November 2004, his opponent, Yanukovych, won the election, but when the election appeared to be fraudulent, a re-vote was conducted in December 2004. The pro-Western Yushchenko won this second election by a narrow margin of roughly 52% to Yanukovych’s 44%. When Yanukovych contested the results, the Ukraine’s Supreme Court ruled that the results of the second vote would stand. Viktor Yushchenko was inaugurated as President of the Ukraine on January 23, 2005.

Description of the Poison

Forensic toxicologists confirmed that dioxin was the poison that caused Viktor Yushchenko’s ailment. He had 1000 times the normal concentration of dioxin in his blood. His initial severe abdominal pains suggested that the poison had been placed in his food.

Dioxins are highly toxic chemical compounds produced in small concentrations when organic substances are burned in the presence of chlorine. Dioxins are by-products of factories that use chlorine in the cleaning and manufacturing of paper, textiles, pesticides, and plastics. Major sources of dioxins are coal-fired utilities, metal smelters, diesel trucks, and the burning of wood treated with preservatives. Dioxins are also in cigarette smoke from cigarettes that contain chlorine-based pesticides or chlorine-bleached paper. Because dioxins are found in a wide range of common substances (such as food packaging, tampons, etc.), all people receive small doses of dioxins. However, relatively small doses do not seem to pose health hazards.

One of the most obvious symptoms of dioxin poisoning is chloracne, a condition of painful blisters that cause the face to be swollen and greyish colour. Chloracne is not harmful to a person’s overall health, but it does make the victim appear much older. Other immediate symptoms of dioxin poisoning include nausea, vomiting, and abdominal pain.

The long-term effects of dioxin poisoning include cancer, liver damage, reproductive organ damage, diabetes, and heart disease. Doctors predict Yushchenko’s damaged liver will return to normal functioning, but because dioxins remain in the body for long periods, some of the long-term effects of dioxin poisoning could appear later in his life.

Conclusion

Viktor Yushchenko’s supporters accused his political opponent, Viktor Yanukovych, of the poisoning, claiming that the Russian government was responsible for supplying the dioxin. Yanukovych and his supporters have denied any involvement. After Yushchenko was elected, he announced he would provide proof that his political opponent had tried to assassinate him. To date, this proof had not been revealed by Yushchenko or his supporters.

An investigation by the Ukrainian Security Service and the Ukrainian Prosecutor-General’s Office has not identified the culprit(s) responsible for the poisoning of Viktor Yushchenko.

Use the above information from this case study to answer the questions in your assignment.

- Source: Associated Press

A notorious incident of mass suicide and mass murder involving the use of poison occurred in 1978 in the communal settlement of Jonestown, Guyana, located between Venezuela and Brazil, South America. Founded in the mid-1970s by charismatic cult leader Jim Jones, the commune existed for only a few years. Then, 913 people in the commune died in an act of mass suicide and mass murder on the evening of November 18, 1978.

Background: Jim Jones

James Warren "Jim" Jones was an ordained minister who moved his congregation from Illinois to California in 1965, settling near San Francisco in 1971 where Jones began the People’s Temple, a religious cult. In 1974 and for various reasons, Jones decided to build his version of a perfect religious society in Guyana where he would be free from intervention by people who were concerned about family members who had joined his cult.

Jim Jones, founder of Jonestown
- Source: Associated Press

Jonestown

In 1974, Jones leased about 12 square kilometres of jungle in Guyana and personally oversaw the construction of a small commune that by 1978 became home to more than 1000 followers. Far from the original promise of socialistic paradise, Jonestown became known as a despicable form of indulgence for Jones. He reportedly tortured followers for minor infractions and regulated food supplies as a further means of control.

Various forms of indoctrination were practised including what became known as white nights—tests of loyalty and faith in Jones’ leadership that involved drinking Kool-Aid® that followers were tricked into believing contained poison. Everyone who drank the mixture survived and was honoured. Those who refused were shamed into future acts of compliance as signs of their faith in Jones. In effect, Jim Jones was conducting rehearsals for a mass suicide that he referred to as “revolutionary suicide”.

Flashpoint

Acting upon allegations of human rights abuses and the possibility that people were being held in Jonestown against their wills, Leo Ryan, a US Congressman, flew to Guyana on November 14, 1978. A contingent of media representatives as well as family members of some of the residents of Jonestown accompanied him to the commune the night of November 17. By the morning of November 18, several people had asked to leave with Ryan and return to the United States. This greatly upset Jones who nevertheless allowed Ryan, his entourage, and several defectors to go to the airport.

Shortly before take-off, a violent ambush occurred. Nine armed men fired numerous rounds, killing Congressman Ryan, three journalists, and a person who was trying to defect. Twelve people accompanying Ryan, media representatives, and defectors were wounded, several of them seriously. All the injured were left at the airport where they lay until morning when they were rescued by the Guyanese government.

The Mass Poisoning

After the airport ambush, the gunmen returned to Jonestown where, on the evening of November 18, Jim Jones organized another white night. This time, however, the grape-flavoured Kool-Aid® was actually spiked with poison. Forensic toxicologists determined that the poison was potassium cyanide and that the painkilling drug Valium® was added to the Kool-Aid®. Convinced that American-sponsored Guyanese soldiers would soon slaughter them anyway, all the followers loyal to Jones ensured that the entire commune lined up to participate in this mass suicide. Children were forced to go first; grieving parents soon joined them.

The Poison

Potassium cyanide (KCN) is a colourless crystalline compound similar in appearance to sugar and highly soluble in water. KCN smells like bitter almonds and is highly toxic. KCN inhibits the production of ATP in the cells by blocking cellular respiration in the mitochondria. Cyanide poisoning causes a red facial complexion in the victim because the tissues are unable to use the oxygen in the blood.

More that 200 mg of potassium cyanide ingested results in loss of consciousness in ten seconds to several minutes depending on the body’s immune system and the amount of food in the stomach. After about 45 minutes, the body convulses and then goes into a coma. If not treated, the person then has a heart attack and dies within two hours.

The Aftermath

That night in Jonestown, 913 people, including 276 children, died of cyanide poisoning. Loyal followers of Jim Jones murdered perhaps more than 100 who tried to resist. Jones was found dead of a gunshot wound to the head—thought to have been self-inflicted. Only a few autopsies were conducted. Jonestown was abandoned by the few remaining members; it was destroyed by fire in 1983. Today, Jonestown is one of the most notorious mass suicides and mass murders in history.

Use the above information from this case study to answer the questions in your assignment.