This article proposes a model for the in vivo incorporation of drugs of forensic interest into bone tissue.
Currently, the inability to meaningfully and reliably conduct toxicological testing on human skeletal material is a significant gap in forensic practice, especially since the United States declared opioid use a public health emergency and chemical weapon use in both mass and isolated attacks is prevalent in international news. In recent years, an increasing number of case studies and experiments have been published to fill this knowledge gap. These papers are reviewed in this article, and their valuable and pertinent findings are discussed; however, the lack of an established model for the incorporation of drugs of forensic interest into bone has limited interpretation of results and delayed adoption of skeletal toxicology methods into accepted forensic practice. The model proposed in this article is derived from known pathways for in vivo incorporation of compounds and analytes not of traditional forensic interest into bone tissue and is based on principles of ionic exchange, adsorption, and substitution. Testing and understanding these pathways may better guide skeletal toxicological experimentation, resulting in methods more tailored to human bone as a unique, largely inorganic matrix, as well as in increased interpretability of results. Further, the proposed model suggests possible novel applications for the field of skeletal toxicology on the humanitarian stage. Indeed, based on their chemical properties, chemical weapon nerve agents should be investigated as xenobiotics that may incorporate into the human skeleton at relatively elevated levels. If nerve agents can be isolated from skeletal remains, the field of skeletal toxicology may be able to offer important contributions to human rights investigations of mass graves. (publisher abstract modified)