This article reports on the work of the Miami-Dade County medical examiner’s office to develop a quick method for screening fluids for hundreds of drugs at one time, providing more detail about substances found in postmortem blood and tissues with a higher degree of confidence; the article’s sections discuss the creation of an internal searchable library for drugs and their analogues as well as implications for practice.
The illicit drug market is constantly evolving. New drugs (called novel psychoactive substances) are steadily emerging, evading detection and legal consequences. Postmortem laboratories need cost-effective methods to quickly test for numerous drugs. Dr. Diane Moore, a toxicologist for the Miami-Dade County Medical Examiner, sought more detail about substances found in postmortem blood and tissues and a higher degree of confidence in their identification. With National Institute of Justice funding, her department purchased instrumentation to perform liquid chromatography tandem mass spectrometry (LC/MS/MS) to improve their workflow and augment their current screening procedure using gas chromatography-mass spectrometry (GC/MS). Dr. Moore’s team developed a method for rapid, large-scale blood sample screening to augment current procedures and replace their traditional approach to toxicology testing. Optimally, they were seeking to develop operating procedures that would simultaneously scan for a wide range of drugs while still identifying and differentiating among closely related drugs. The team compared their results to current methods and created a searchable library that includes relevant drugs found in present-day toxicology screens.