Browse the latest forensic toxicology articles or search the collection.
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Why did a traffic-injury study compare blood results with oral-fluid results?
A case-control study can compare how often drugs are found in injured drivers and drivers in ordinary traffic. The comparison becomes harder when the two groups provide different specimen types. How the study handled the mismatch Bogstrand and colleagues used blood from injured drivers and oral fluid from drivers sampled in moving traffic. They applied…
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What does a rapid reversal add to a suspected zopiclone reaction timeline?
A change shortly after a reversal drug is administered can inform a toxicology opinion. In one intensive-care case, it helped the authors assess whether zopiclone contributed to agitation and confusion. The order of events mattered Jordahn and colleagues described an 81-year-old patient who was receiving respiratory support after an exacerbation of chronic obstructive pulmonary disease…
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What did two positive specimens add to a pediatric camphor case?
A household exposure history can suggest which compounds belong in a toxicology review. Results from two kinds of specimen can provide additional evidence without independently measuring the amount ingested. The reported sequence A two-year-old developed seizures after a reported ingestion of part of a camphor tablet. The family described the exposure and a camphor odor,…
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What does a logic model establish about an intervention for street benzodiazepine use?
An intervention can be fully described before its benefits and risks have been measured in patients. A Scottish project on high-risk benzodiazepine use alongside opioid use is an example of that distinction. What the development study produced The team held three workshops with clinicians, researchers and people with lived experience, each followed by a separate…
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How can an overdose timeline distinguish early cardiac findings from later weakness?
An overdose chart may contain abnormalities that begin hours or days apart. Treating them as one event can obscure the evidence supporting each finding. A published amitriptyline case shows why a timeline should track several systems separately. The case had an early phase and a later phase The patient arrived with altered consciousness, hyperthermia, acidosis…
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How did troponin testing affect a study of myocardial injury after midazolam exposure?
A study can define injury using a blood test, but it also needs a rule for cases in which no test was ordered. That rule matters when comparing different hospitals, types of surgery or times of day.
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How much can pill bottles establish in a mixed-drug poisoning case?
The scene suggested several possible exposures A report described an adult found unresponsive near containers for dalfampridine, valacyclovir and temazepam. The emergency team documented seizures and obtained drug measurements. The report recorded a dalfampridine concentration of 530 ng/mL and followed the patient’s clinical and EEG findings in intensive care. The evidence differs for each drug…
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Why should a benzodiazepine withdrawal timeline account for other drugs stopped at the same time?
Multiple withdrawals appeared in the same records Researchers reviewed 82 cases of acute benzodiazepine withdrawal at an academic medical center. Thirty-one cases involved concurrent withdrawal from another drug. Opioids were the most common, with 25 cases. The study relied on charts and diagnostic coding to identify cases and document exposures. The label does not assign…
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Why report days with a potential interaction as well as patients with one?
Two measures of a medication overlap A study in a maternal intensive care unit classified potential interactions from medication records. About one-third of patients had a combination classified as a severe potential interaction at least once. The paper also tracked the portion of the ICU stay during which a severe potential combination was present. Duration…
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Can one SCRAM episode count against two calendar days?
A sensor episode and a calendar day are different units Barnett and colleagues used transdermal alcohol monitoring in a small randomized study of incentives for reducing drinking. An episode that started on one date sometimes continued past midnight. The investigators reported their main outcome with the next day counted both ways, depending on the analysis.…
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Can opioid and sedative orders months apart establish co-use?
The study counted orders in calendar windows Hartung and colleagues examined prescription orders in a network of safety-net community health centers from 2009 to 2018. For each six-month calendar period, they classified a patient as co-prescribed if the record contained both an opioid order and a sedative-hypnotic order. The latter category included benzodiazepines and medicines…
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How can grouping cold medicines change the apparent ranking of overdose substances?
The ranking mixes a category with individual drugs A regional hospital in Sendai analyzed 577 emergency presentations for drug or chemical overdose from 2010 through 2020. Its leading category grouped over-the-counter antipyretic analgesics and cold medicines, with 97 mentions. The next reported entries were individual agents, including flunitrazepam, etizolam and brotizolam. The label determines what…
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What can a zolpidem withdrawal timeline establish in a disputed case?
The report describes a specific exposure history Mao and colleagues described a patient with bipolar disorder and a history of taking zolpidem above prescribed amounts. After inpatient admission and cessation, the clinical team documented symptoms that included rebound insomnia and anxiety, followed by other symptoms including reported seizure-like events and hallucinations. Order is evidence, with…
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Why should seizure response and treatment retention be reported separately?
What the cohort followed A single-center retrospective study followed 85 adults with drug-resistant focal epilepsy who still had seizures while taking cenobamate and subsequently received low-dose clobazam. Researchers tracked seizure outcomes, adverse reactions and whether participants remained on treatment. The percentages describe different events The investigators reported an estimated 12-month treatment retention rate of 83.1%.…
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How can treatment selection affect a bronchoscopy sedation comparison?
How the groups were formed A prospective study of 80 adults undergoing flexible bronchoscopy compared ketofol, a ketamine–propofol mixture, with midazolam. The care team selected the regimen based on clinical factors that included anticipated airway tolerance, procedural requirements, comorbidities and clinician familiarity. The decision was recorded before the procedure, but allocation was not random. Read…
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Whole-Blood THC Detection and Driving-Related Test Performance
A crossover study measured whole-blood THC and computerized performance as separate outcomes after vaporized low-THC flower.
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Why a Single-Dose CBD Study May Miss Accumulation
A 36-week canine study compared CBD blood measurements early and later in daily administration.
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How to Read a Rat Study of CBD Exposure During Pregnancy
A controlled rat study examined fetal growth, placental structure and gene expression after gestational CBD exposure.
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What a Fragile X CBD Gel Pilot Can Establish
An open-label pediatric study used several rating scales to follow changes over 12 weeks.
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What a CBD Label Can Establish in an Exposure Review
A study of 80 commercial CBD products illustrates the difference between a package claim and a laboratory measurement.