The Invisible Killer: identifying new designer drugs in postmortem forensic toxicology

For the first time in Ireland, the State Laboratory have developed and implemented an analytical strategy allowing postmortem forensic toxicology samples to be screened for previously 'invisible' designer drugs outside the traditional scope of testing. This project has supported the Irish Coroners service in solving death investigations that previously could not have been satisfactorily concluded.

Innovation Summary

Innovation Overview

Novel psychoactive substances (NPS), more commonly known as designer drugs, have exploded onto the Irish market posing a significant public health challenge. Ireland is reported to have one of the highest levels of designer drug use in Europe thus creating a significant challenge for the human toxicology postmortem testing strategy where traditionally samples were only screened for a defined cohort of prescribed and illicit drugs. The primary challenge was accurately capturing a ‘snapshot’ of the rapidly evolving nature of the Irish drug market at any particular point in time to ensure the client received the most relevant and comprehensive toxicology screen available.

New drug products are easy to access online and now appear regularly, often in response to changes in legislative control e.g. in 2015 98 new European NPS alerts were issued. Very little is generally known about these new products, they often have very similar chemical structures and can be highly toxic in small amounts. Designer drugs are generally ‘invisible’ in traditional toxicology screens and are not available in commercially purchased databases. Additionally, there is very limited HRLCMS expertise in Ireland so collaborative analytical support was limited.

Finally, postmortem case history information was often limited, absent or incorrect (e.g. mislabeled products purchased online) adding to the overall analytical challenge. Our primary objectives were to:

• Develop an analytical approach that could tackle the rapid and continued emergence of new drug substances.

• Proactively monitor market trends and include new drugs as soon as feasible.

• Retrospectively analyze data in suspect toxicology cases.

• Provide our clients with a comprehensive world-class toxicology service.

Major beneficiaries of the innovation:

• With earlier identification of novel psychoactive substances now being achieved, relevant public health alerts can be issued in a more timely fashion.

• Due to our proactive monitoring of general population drug use trends, our toxicology screens accurately meet the evolving needs of the Irish Coroner’s Service and minimize cases where no satisfactory cause of death can be established.

• Retrospective analysis of data without physical re-analysis of the sample allows cases to be rapidly reassessed as additional NPS data comes to light. Additionally,
the sample volume is no longer an issue as we don't have to re-analyze limited sample cases.

• We regularly update and readily share all data with our wider network of toxicology laboratories and drug support services to support them in achieving their own goals.

Innovation Description

Innovation Development

Innovation Reflections

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Year: 2015
Level of government: National/Federal government


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