[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-241629-105":3,"detail-sidebar-cat-1-en-105":84,"doc-detail-241629-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":77,"head_meta":79,"extra_data":81,"updated_unix":83},105,"en","non-standard-toxicology-dr-stephen-morley","Non Standard Toxicology - Dr Stephen Morley","","This document, titled \"Non Standard Toxicology,\" by Dr. Stephen Morley from University Hospital Leicester, UK, outlines principles and practices in forensic toxicology, particularly concerning post-mortem investigations. It details drug history, social history, toxicology, microbiology, environmental factors, previous medical history, and witness information relevant to determining the cause of death. The document emphasizes systematic screening for illicit, therapeutic, and social drugs that may have contributed to death or affected cognition, including specific considerations for deaths in fire and environmental toxins. It outlines an ideal \"Routine\" Post Mortem Toxicology protocol in the UK, including Ethanol, Paracetamol, Salicylate, and drug screens (GCMS or LCMS), while noting limitations such as the inability to detect COHb and the need for expert interpretation of extensive compound libraries. Additional specific tests like vitreous biochemistry, COHb/cyanide, volatiles, new psychoactive substances, synthetic fentanyls, and pesticides are discussed. The document stresses the importance of collecting as many relevant samples as possible, including ante-mortem samples if available, and addresses potential cost implications. It also tackles challenges with decomposed or badly burned bodies and critically questions the interpretation of drug quantitation in post-mortem cases due to post-mortem redistribution and unreliable reference values, advocating for never interpreting results in isolation. The document references a study in Br J Pharmacology (2008) investigating 129 drugs, focusing on upper concentrations within the study population to assess drug-related deaths.",{"@graph":14,"@context":76},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/general/","General",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/non-standard-toxicology-dr-stephen-morley/241629/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/non-standard-toxicology-dr-stephen-morley/241629.png","ImageObject",442,249,{"name":42,"@type":43},"Jiven","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-09-19","2026-09-12",true,{"@type":52,"interactionType":53,"userInteractionCount":30},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68,72],{"name":59,"@type":60,"acceptedAnswer":61},"What is the main focus of the \"Non Standard Toxicology\" document?","Question",{"text":62,"@type":63},"The document focuses on principles and practices in post-mortem forensic toxicology, aiming to determine the cause of death through systematic drug and toxin screening.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"What are the limitations of standard post-mortem toxicology screens?",{"text":67,"@type":63},"Standard screens may not detect all relevant substances, such as COHb, and extensive compound libraries require expert interpretation. Substances not in the library will not be reported, and interpretation of drug concentrations can be complicated by post-mortem redistribution.",{"name":69,"@type":60,"acceptedAnswer":70},"What are some specific tests mentioned for post-mortem toxicology?",{"text":71,"@type":63},"Specific tests include vitreous biochemistry, COHb/cyanide detection, volatile substance analysis, screening for new psychoactive substances and synthetic fentanyls, and pesticide analysis, particularly in relevant geographical contexts.",{"name":73,"@type":60,"acceptedAnswer":74},"Why is interpreting drug quantitation in post-mortem cases challenging?",{"text":75,"@type":63},"Interpreting drug quantitation is challenging due to post-mortem redistribution and the reliability of reference values. Results should never be interpreted in isolation and require expert analysis.","https://schema.org",{"og:url":32,"og:type":78,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":80,"canonical":32},"index,follow",{"doc_id":82,"site_id":7},241629,1789178320,{"code":4,"msg":85,"data":86},"success",[87,92,97,102,107,112,117,122,127],{"id":88,"doc_module":22,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},11,"Presentations",90,"presentations",{"id":93,"doc_module":22,"doc_module_name":25,"category_name":94,"show_sort_weight":95,"slug":96},12,"Resumes",80,"resumes",{"id":98,"doc_module":22,"doc_module_name":25,"category_name":99,"show_sort_weight":100,"slug":101},14,"Invoices",70,"invoices",{"id":103,"doc_module":22,"doc_module_name":25,"category_name":104,"show_sort_weight":105,"slug":106},15,"Posters",60,"posters",{"id":108,"doc_module":22,"doc_module_name":25,"category_name":109,"show_sort_weight":110,"slug":111},16,"Social Media",50,"social-media",{"id":113,"doc_module":22,"doc_module_name":25,"category_name":114,"show_sort_weight":115,"slug":116},17,"Forms",40,"forms",{"id":118,"doc_module":22,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},18,"Letters",30,"letters",{"id":123,"doc_module":22,"doc_module_name":25,"category_name":124,"show_sort_weight":125,"slug":126},21,"Paper Templates",5,"papers-templates",{"id":128,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":4,"slug":129},158,"general-158",{"code":4,"msg":85,"data":131},{"doc_id":82,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":22,"category_id":128,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":30,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":118,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":83,"read_time":143},1099513958607,"https://ap-avatar.wpscdn.com/avatar/100002390cf8733938c?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778829742770036399","Non Standard Toxicology  \nDr Stephen Morley  \nUniversity Hospital Leicester  \nUK  \nDrug history  \nSocial history  \nScene of death  \nToxicology  \nMicrobiology  \nEnvironment  \nPrevious medical history  \nWitnesses  \nAutopsy findings  \nLeicester / international systematic screens  \n• Screen for illicit drugs that may have caused death  \n• Screen for therapeutic drugs that may cause death  \n• Screen for social drugs that may cause death  \n• Screen for all above that may affect cognition  \n• Deaths in fire  \n• Environmental toxins (pesticide/ herbicide)  \nIdeal “Routine” Post Mortem Toxicology (UK)  \n• Ethanol (Blood, urine vitreous)  \n• Paracetamol (Blood) Salicylate (Blood)  \n• Drugs screen (blood and urine)  \n• GCMS screen or LCMS screen  \n• “full” unknown screen-1000s compounds-relevance unclear so needs expert interpretation.  \n• Does not detect COHb  \n• If not in the library then will not be reported  \n• Quantifications  \nAdditional / specific tests Vitreous biochemistry  \nBeta OH butyrate-if acetone > (5 mg/100mL) on ethanol screen COHb/cyanide  \nVolatiles (butane/propane)  \nNew psychoactive substances  \nSynthetic fentanyls  \n(pesticides in Thailand / Caribbean)  \nWhat samples to collect  \n• I say……….as many as possible-but I will only analyse those I see relevant  \n• I say……….any ante mortem if available  \n• Costs?– more tests cost more money  \nDecomposed / badly burned bodies  \n• No blood  \n• No urine  \n• No vitreous  \n• No chance……?????  \nShould drug quantitation happen  \n• It is possible to quantify but  \n• What does a post mortem concentration mean if you take into account post mortem redistribution?  \n• Are the reference values reliable?  \n• NEVER interpret in isolation  \nDid the drug cause death?  \nFerner Br J Pharmacology 2008  \n129 drugs investigated  \nUpper 90/95/97.5 concentrations of study population","cbCaidB2z23vJIdH","https://ap.wps.com/l/cbCaidB2z23vJIdH","pdf",1245379,"English","# Non Standard Toxicology\n## Dr Stephen Morley\n## University Hospital Leicester\n## Drug history\n## Social history\n## Scene of death\n## Toxicology\n## Microbiology\n## Environment\n## Previous medical history\n## Witnesses\n## Autopsy findings\n## Leicester / international systematic screens\n## Ideal “Routine” Post Mortem Toxicology (UK)\n## Additional / specific tests Vitreous biochemistry\n## What samples to collect\n## Decomposed / badly burned bodies\n## Should drug quantitation happen\n## Did the drug cause death?","[{\"question\":\"What is the main focus of the \\\"Non Standard Toxicology\\\" document?\",\"answer\":\"The document focuses on principles and practices in post-mortem forensic toxicology, aiming to determine the cause of death through systematic drug and toxin screening.\"},{\"question\":\"What are the limitations of standard post-mortem toxicology screens?\",\"answer\":\"Standard screens may not detect all relevant substances, such as COHb, and extensive compound libraries require expert interpretation. Substances not in the library will not be reported, and interpretation of drug concentrations can be complicated by post-mortem redistribution.\"},{\"question\":\"What are some specific tests mentioned for post-mortem toxicology?\",\"answer\":\"Specific tests include vitreous biochemistry, COHb/cyanide detection, volatile substance analysis, screening for new psychoactive substances and synthetic fentanyls, and pesticide analysis, particularly in relevant geographical contexts.\"},{\"question\":\"Why is interpreting drug quantitation in post-mortem cases challenging?\",\"answer\":\"Interpreting drug quantitation is challenging due to post-mortem redistribution and the reliability of reference values. Results should never be interpreted in isolation and require expert analysis.\"}]","Non Standard Toxicology - Dr Stephen Morley | PDF",6]