by B Zedeck
azepines. At trial, the defense expert testified that the presence
of benzodiazepines in urine is not indicative of impairment. The
drug might have been consumed several days prior to the acci-
dent. The jury found the defendant not guilty.
What tests would you have done at the time of the accident to
help establish that the defendant was driving while impaired?
Answer to Case A: Bloodshot eyes and poor coordination are hall-
mark signs of marijuana intoxication. The driver may have fin-
ished smoking marijuana before getting into the car, explaining the
absence of odor, or may have ingested the marijuana. The level of
alcohol is too low to account for poor coordination and the failing of
the field sobriety tests. A urine sample should be collected and tested
by EMIT and, if positive for cannabinoids, confirmed by GC/MS.
120 Forensic Pharmacology
Answer to Case B: The finding of morphine is likely due to poppy
seed bagels eaten at breakfast, but the level of morphine would be
too low to exert any effects. Also, slightly elevated vital signs are not consistent with morphine’s effects. The quarterback’s unusual
behavior before passing out and the nonresponsive stare are typical
signs of PCP intoxication. Someone may have slipped the drug into
Team A quarterback’s Gatorade just before the good-luck toast.
Answer to Case C: Two types of analysis would have been help-
ful. An analysis of blood would have been a better indicator of
causality than a urine sample. If benzodiazepines were found in
the blood, the type of benzodiazepine and its concentration would
have helped establish whether or not the driver was impaired. An
examination by a DRE might have revealed any drug-related phys-
iological effects, and performance of field sobriety tests might have
indicated impairment.
Notes
1.DietrichMilles,“Historyof
9.MADD,“FatalitiesandAlcohol-
Toxicology,”Chapter1in Toxicology,
RelatedFatalities.”http://www.
11–23.
madd.org/stats/0,1056,9659_
2.GaryW.Kunsman,“Human
print,00.html.
PerformanceToxicology,”Chapter2
10.NIDA,“NIDAInfofacts:Drugged
in Principles of Forensic Toxicology,
Driving.”http://www.nida.nih.gov/
13–30;andDavidSandler,“Expert
Infofacts/driving.html.
andOpinionTestimony,”Chapter
11.OfficeofNationalDrugControl
16in Medical-Legal Aspects of Drugs,
Policy,“JuvenilesandDrugs.”http://
399–437.
www.whitehousedrugpolicy.gov/
3. Schedules of Controlled Substances,
drugfact/juveniles/index.html.
21USC812.
12.CaliforniaNORML, CaNORML,
4.L.D.Johnston,P.M.O’Malley,
NationalOrganizationforthe
andJ.G.Bachman,“Trendsin
ReformofMarijuanaLaws.http://
AnnualPrevalenceofanIllicit
www.canorml.org.
DrugUseIndexAmong8th,10th
13.NIDA,“GHB.”http://www.nida.nih.
and12thgraders.”http://www.
gov/infofacts/rohypnolghb.html.
monitoringthefuture.org/data/
14.GaryW.Kunsman,“Human
04data/fig04_1.pdf.
PerformanceToxicology,”Chapter2
5.OfficeofNationalDrugControl
in Principles of Forensic Toxicology,
Policy,“JuvenilesandDrugs.”http://
13–30.
www.whitehousedrugpolicy.gov/
15.AdvisoryCommitteeonHuman
drugfact/juveniles/index.html.
RadiationExperiments,PartI,
6.OfficeofAppliedStudies,“Drug
Chapter3,“SupremeCourtDissents
AbuseWarningNetwork,2003:
InvoketheNurembergCode.”http://
InterimNationalEstimatesofDrug-
www.eh.doe.gov/ohre/roadmap/
RelatedEmergencyDepartment
achre/Chap3_4.html.
Visits.”http://www.oas.samhsa.gov/
16.EricChudler,“Ecstasy-MDMA.”
dawn/2K3interimED.pdf.
http://faculty.washington.edu/
7.SubstanceAbuseandMentalHealth
chudler/mdma.html;andNIDA,
DataArchive,“OverallTeenDrug
“Ecstasy.”http://teens.drugabuse.
UseContinuesGradualDecline;But
gov/facts/facts_xtc1.asp.
UseofInhalantsRises.”http://www.
17.NIDA,“Inhalants.”http://www.nida.
monitoringthefuture.org.
nih.gov/ResearchReports/Inhalants/
8.AssociatedPress,“Health:Teenager
Inhalants2.html.
PrescriptionDrugUse.”http://
18.NIDAforTeens:FactsonDrugs,
kyw.com/siteSearch/local_story_
“Anabolic-AndrogenicSteroids.”
111162950.html/resources_
http://teens.drugabuse.gov/facts/
storyPrintableView.
facts_ster1.asp.
121
glossary
Adulterant Asubstancewithpharmacologicaleffectaddedtoorsubsti-
tutedforanotheractivedrug.
Alveoli Terminalaircellofthelungswheregasesareexchanged.
Anabolic Asteroidhormoneresemblingtestosterone,whichstimulates
thegrowthofmuscletissue.
Analog Adrugwhosestructureissimilartothatofanotherdrug.
Androgenic Asubstancecausingmasculinization.
Antibody Asubstanceproducedbytheimmunesystemthatrecognizes
andneutralizesforeignsubstancesinthebody.
Antigen Asubstancethatstimulatestheproductionofantibodiesand
bindstoantibodies.
Ataxia Lackofcoordinationofvoluntarymuscles;unsteadybalance.
Blood-brain barrier Anatomicbarrierpreventingentryofcertainsub-
stancesfrombloodintotheCNS.
Cataplexy Asuddenmuscleweaknessandlossoftonethatcanprevent
narcolepticsfromachievinganormalsleepcycle.
Central nervous system (CNS) Consistsofthebrainandspinalcord.
Chain-of-custody Topreventspecimentampering,documentationof
eachstepfromthepointofcollectiontothereportingoftheresults.
Club drugs Drugsusedatravesites.
CNS SeeCentralnervoussystem.
Cross-tolerance Tolerancetoapharmacologicallysimilardrug;onedrug
maybesubstitutedforanother.
Defendant Apersonagainstwhomanactionisbrought.
Demethylated Theremovalofamethyl(CH3)group.
Designer drug Anydrugthatiscreatedtobechemicallyandpharma-
cologicallysimilartoonelistedinSchedulesItoVandregulatedunder
theCSA.
Diffusion Themovementofasubstancefromanareaofhighconcentra-
tiontoanareaoflowconcentration.
122
Glossary
Diluent Anagentwithoutpharmacologicaleffectusedtodiluteanactive
drug.
Dissociative anesthetic Adrugthatproducessignificantanalgesiawhile
thepatientremainsawakeandfeelsremovedfromthesurroundingenvi-
ronment,wit
houtdepressingvitalsigns.
Drug Achemicalthataffectsbiochemicalandphysiologicalprocessesoftis-
suesororgansandissometimesusedinterchangeablywiththeword chemical.
Dysphoria Amoodofgeneraldissatisfaction,restlessness,anxiety,dis-
comfort,andunhappiness.
Endoplasmic reticulum Anetworkofconnectingtubulesinsidethecell.
Euphoria Anexaggeratedfeelingofwell-being;mildelation.
Exhume Toremoveabodyfromagrave.
Expert witness Anindividualthatajudgequalifiestoofferanopinion
basedonknowledge,skill,experience,training,andeducation,ifthetesti-
monyisrelevantandreliable.
Forensic science Theapplicationofsciencetolegalissues.
Glucuronide Awater-solublesubstanceproducedbylinkingglucuronic
acidtoanothersubstance.
Half-life Thetimerequiredbymetabolismoreliminationtoreducethe
concentrationofachemicalby50%.
Hallucinogen Achemicalthatalterssight,sound,smell,taste,andtouch
senses,anddisturbsperception,thought,andmood.
In vitro Inglassware,testswithisolatedtissueorwithcellpreparations.
In vivo Inthelivingbody.
Lipophilic Lipidloving;affinitytodissolveinfat.
Metabolite Aproductofmetabolism.
Monoamine oxidase inhibitor (MAOI) Adrugthatinhibitstheenzyme
monoamineoxidase(MAO),therebyincreasingthelevelofneurotrans-
mittersanddrugsmetabolizedbyMAO.
123
Glossary
Nystagmus Involuntaryrotatory,horizontal,orverticalmovementsof
theeyesmostnoticeablewhengazingatrapidlymovingobjectsoratfixed
objectsintheperipheralfieldofview.
Pathology Studyofthestructuralandfunctionalchangesinthebody
causedbydisease.
pH Hydrogenionconcentration.Itisameasureoftheacidityoralkalinity
ofasolution.
Pharmacodynamics Thestudyofadrug’smechanismsofactiononliv-
ingorganismstobringaboutphysiologicalandpathologicalchanges.
Pharmacokinetics Thestudyofadrug’sabsorption,distribution,metab-
olism,andexcretion.
Pharmacologist Anindividualwhobytrainingandexperienceisaspe-
cialistinpharmacology.
Pharmacology Thestudyofachemical’spharmacokineticsandpharma-
codynamics,anditstherapeuticandtoxiceffects.
Physical dependence Astateinwhichtolerancedevelopstoadrug’s
effectsandwithdrawalsymptomsappearintheabsenceofdrug.
Plaintiff Thecomplainingpartyinanactionatlaw.
Plasma Liquidpartofthebloodafterremovingtheredcells,whitecells
andplatelets.
Postmortem redistribution Afterdeath,drugsthatwereconcentrated
inheartandadjacentorgansmayleakbackoutintotheblood,producing
abnormallyhighvalues.
Psychological dependence Lossofcontrolregardingdruguseeither
foritspositiveeffectsorinordertoavoidnegativeeffectswhenthedrugis
unavailable.
Psychosis Aseverelossofcontactwithrealityevidencedbydelusions,
hallucinations,disorganizedspeechpatterns,andbizarreorcatatonic
behaviors.
Psychotomimetic Relatingtoorproducingastateresemblingpsychosis.
Rave Apartyheldatalicensedorunlicensedsite(warehouses,fields),with loud,rhythmictechno,jungle,orzenmusicandlaserlighting,andwhich
mayincludethepresenceofdrugs.
124
Glossary
Recreational drug Adrugnotusedformedicinalpurposesbutforinduc-
ingeuphoriaandavoidingproblems.
Schizophrenia Amentaldisordermanifestedbydelusions,hallucina-
tions,anddisorganizedspeechandbehavior.
Sensitivity Thesmallestamountofthetargetmoleculethatatestcan
detect.
Serum Liquidpartofthebloodremainingafterclotting.
Specificity Abilityofatesttodistinguishbetweenhighlysimilartarget
molecules.
Tolerance Thenecessityoftakingincreasingamountsofasubstanceto
reachdesiredeffects.
Toxicologist Onewhopracticestoxicology.
Toxicology Thestudyofachemical’spharmacokineticsandpharmacody-
namics,anditsadverseortoxiceffects.
Vitreous humor Fluidinsidetheeyeballusefulforforensicstudies
becauseitisnotreadilycontaminated,andtheconcentrationofdrugis
relativelystable.
Xenobiotic Achemicalthatisstrangeorforeigntothebody.
125
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