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Medico-legal assessment of methamphetamine and amphetamine serum concentrations-what can we learn from survived intoxications?
Int J Legal Med. 2017 Sep; 131(5):1253-1260.IJ

Abstract

Medico-legal experts are increasingly enlisted to assess the methamphetamine and amphetamine serum concentrations after a criminal offense. However, since criminal users rarely provide useful information to medico-legal experts regarding the substances abused, when the substance(s) was/were used, dose of ingestion tools are needed to interpret the analytical data, which can be used as objective evidence in such cases. A comparative series of methamphetamine and amphetamine serum concentrations were used to analyze the frequency of concentrations, to determine methamphetamine/amphetamine concentration ratios, and prove them as a tool to distinguish pure methamphetamine from mixed amphetamine/methamphetamine ingestion. Additionally, two cases of survived accidental methamphetamine intoxication, resulting from ingestion smuggling which was longitudinally monitored, and pharmacokinetic parameters were assessed. In a series of 628 samples where the most frequent concentration of methamphetamine exceeded the therapeutic level, there was a strong correlation suggesting pure methamphetamine consumption, when the ratios of methamphetamine/amphetamine concentrations were within the range between 3 and 10. In the two cases of methamphetamine bodypacking, the relevant serum concentrations of methamphetamine and amphetamine, which could be measured up to 9 days after ingestion, indicated a decrease of the methamphetamine/amphetamine ratios in an exponential manner. However, the ratios were not always within the range between 3 and 10. Lastly, the course of the serum concentrations suggested an increase of the apparent elimination half-life of methamphetamine. In terms of the objective evidence required in criminal law, calculating methamphetamine/amphetamine concentration ratio is not a suitable to means to distinguish pure methamphetamine intake and that of mixed amphetamine/methamphetamine abuse in an individual case. Instead, methamphetamine high serum concentrations and the possible increase in apparent elimination half-life suggest that an extended detection period may be used to distinguish between "illicit use" as compared to "therapeutic use" of methamphetamine.

Authors+Show Affiliations

Institute of Legal Medicine, University of Halle-Wittenberg, Franzosenweg 1, D-06112, Halle, Germany. marko.weber@uk-halle.de.Institute of Legal Medicine, University of Halle-Wittenberg, Franzosenweg 1, D-06112, Halle, Germany.Institute of Legal Medicine, University of Halle-Wittenberg, Franzosenweg 1, D-06112, Halle, Germany.Institute of Legal Medicine, University of Halle-Wittenberg, Franzosenweg 1, D-06112, Halle, Germany.Institute of Legal Medicine, University of Halle-Wittenberg, Franzosenweg 1, D-06112, Halle, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28509940

Citation

Weber, Marco, et al. "Medico-legal Assessment of Methamphetamine and Amphetamine Serum Concentrations-what Can We Learn From Survived Intoxications?" International Journal of Legal Medicine, vol. 131, no. 5, 2017, pp. 1253-1260.
Weber M, Lessig R, Richter C, et al. Medico-legal assessment of methamphetamine and amphetamine serum concentrations-what can we learn from survived intoxications? Int J Legal Med. 2017;131(5):1253-1260.
Weber, M., Lessig, R., Richter, C., Ritter, A. P., & Weiβ, I. (2017). Medico-legal assessment of methamphetamine and amphetamine serum concentrations-what can we learn from survived intoxications? International Journal of Legal Medicine, 131(5), 1253-1260. https://doi.org/10.1007/s00414-017-1607-5
Weber M, et al. Medico-legal Assessment of Methamphetamine and Amphetamine Serum Concentrations-what Can We Learn From Survived Intoxications. Int J Legal Med. 2017;131(5):1253-1260. PubMed PMID: 28509940.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Medico-legal assessment of methamphetamine and amphetamine serum concentrations-what can we learn from survived intoxications? AU - Weber,Marco, AU - Lessig,Rüdiger, AU - Richter,Carolin, AU - Ritter,Axel P, AU - Weiβ,Ilona, Y1 - 2017/05/16/ PY - 2017/04/05/received PY - 2017/05/03/accepted PY - 2017/5/17/pubmed PY - 2018/8/17/medline PY - 2017/5/17/entrez KW - Amphetamine KW - Bodypacker KW - Crystal meth KW - Interpretation of toxicological analysis KW - Legal medicine KW - Methamphetamine SP - 1253 EP - 1260 JF - International journal of legal medicine JO - Int. J. Legal Med. VL - 131 IS - 5 N2 - Medico-legal experts are increasingly enlisted to assess the methamphetamine and amphetamine serum concentrations after a criminal offense. However, since criminal users rarely provide useful information to medico-legal experts regarding the substances abused, when the substance(s) was/were used, dose of ingestion tools are needed to interpret the analytical data, which can be used as objective evidence in such cases. A comparative series of methamphetamine and amphetamine serum concentrations were used to analyze the frequency of concentrations, to determine methamphetamine/amphetamine concentration ratios, and prove them as a tool to distinguish pure methamphetamine from mixed amphetamine/methamphetamine ingestion. Additionally, two cases of survived accidental methamphetamine intoxication, resulting from ingestion smuggling which was longitudinally monitored, and pharmacokinetic parameters were assessed. In a series of 628 samples where the most frequent concentration of methamphetamine exceeded the therapeutic level, there was a strong correlation suggesting pure methamphetamine consumption, when the ratios of methamphetamine/amphetamine concentrations were within the range between 3 and 10. In the two cases of methamphetamine bodypacking, the relevant serum concentrations of methamphetamine and amphetamine, which could be measured up to 9 days after ingestion, indicated a decrease of the methamphetamine/amphetamine ratios in an exponential manner. However, the ratios were not always within the range between 3 and 10. Lastly, the course of the serum concentrations suggested an increase of the apparent elimination half-life of methamphetamine. In terms of the objective evidence required in criminal law, calculating methamphetamine/amphetamine concentration ratio is not a suitable to means to distinguish pure methamphetamine intake and that of mixed amphetamine/methamphetamine abuse in an individual case. Instead, methamphetamine high serum concentrations and the possible increase in apparent elimination half-life suggest that an extended detection period may be used to distinguish between "illicit use" as compared to "therapeutic use" of methamphetamine. SN - 1437-1596 UR - https://www.unboundmedicine.com/medline/citation/28509940/Medico_legal_assessment_of_methamphetamine_and_amphetamine_serum_concentrations_what_can_we_learn_from_survived_intoxications L2 - https://dx.doi.org/10.1007/s00414-017-1607-5 DB - PRIME DP - Unbound Medicine ER -