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​Toxicology
​Section 7

7.0 Q: What is toxicology?
A: Toxicology is the examination of bodily fluids or tissue for the purposes of detecting drugs, alcohol, poisons, and other substances/elements.

7.1 Q: What does toxicology test for?
A: In order to answer this question you must first understand who is testing the sample, and for what purpose the testing is being conducted.  Toxicology tests are usually broken down into panels or screens that detect different combinations of drugs, from broad to specific.

When toxicology is done at a hospital it is usually a simpler test comprised of grouping common substances of abuse into categories such as opiates, amphetamines, ethanol/alcohols, etc.  These test are usually very basic and qualitative as opposed to quantitative, meaning they will tell you positive or negative regarding these categories, but not the specific amounts present in the sample.

In private and forensic autopsies, a more comprehensive ‘coroner or expanded toxicology screen’ is usually ran through an actual toxicology center/specialist.  These screens usually include a panel of approximately 150-200 of the most common over-the-counter, prescription, and illegal drugs that are used in society. The list of drugs usually incorporates variations of drugs to include generic medications, but will not include drugs that people aren’t typically capable of overdosing on (e.g. antibiotics, allergy medications, etc.). These screens will often report only the drugs that come back positive, or were confirmed to be present in the sample. You may contact the laboratory that conducts the test to find out the specific drugs that are included in a test (this information is often found on the lab’s website).

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In bigger more advanced toxicology companies, there are additional tests for rare poisons, heavy metals, and other very specific compounds and their analogs.  These test are considered specialized and may be very expensive.

7.2 Q: Is there a toxicology test for everything?
A: The answer is definitely ‘no’.  There are a variety of screens that test for common substances that get more comprehensive with increased price. When more specialized or specific testing is sought, the client must know what drug or poison they want to test for (what drug is suspected). Toxicology labs are consistently adding more and more capabilities as drugs are continuously produced both pharmaceutically and illegally. (For more information refer to 7.1 above)

7.3 Q: What if I suspect some kind of poisoning?
A: Similar to 7.2 above, routine toxicology only includes common drugs of use/abuse and poisons are often not tested during these screens.  Most credible labs will be capable of testing for poisons, but they must be specifically requested by name. These labs need to know what they are testing for specifically in order to calibrate their equipment appropriately.

7.4 Q: Does embalming effect toxicology?
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A: Embalming definitely affects toxicology but the extent is related to what kind of embalming took place, what sample is being tested, how strong the chemicals were, and multiple other factors.  When arterial blood is replaced with embalming fluid, any remaining blood in the body would be less reliable for testing. Liver samples are often used for toxicology on bodies that have been embalmed.  Refer to 5.13 for more information about how embalming affects an autopsy.
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