Medico-legal assessment of methamphetamine and amphetamine serum concentrations-what can we learn from survived intoxications?
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.
['Weber|Marco|M|http://orcid.org/0000-0002-6666-0592', 'Lessig|Rüdiger|R|', 'Richter|Carolin|C|', 'Ritter|Axel P|AP|', 'Weiß|Ilona|I|']
D000328:Adult D000661:Amphetamine D000075066:Body Packing D000066448:Driving Under the Influence D062787:Drug Overdose D008401:Gas Chromatography-Mass Spectrometry D006207:Half-Life D006801:Humans D008297:Male D008694:Methamphetamine D008875:Middle Aged D009294:Narcotics D015813:Substance Abuse Detection
Methamphetamine Amphetamine Bodypacker Crystal meth Interpretation of toxicological analysis Legal medicine