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Drug Primer: Difluoroethane (DFE)
By Kevin Shanks, D-ABFT-FT
1,1-Difluoroethane (DFE) is a chemical compound that belongs to the family of hydrofluorocarbons, also known as HFCs. DFE has a chemical formula C2H4F2 and is a colorless, odorless gas at room temperature and is commonly used as a refrigerant (HFC-152a or R-152a) in air conditioning and refrigeration systems. It is also used as a propellant in aerosol products, such as cleaning sprays for electronics, computer keyboards, and other sensitive equipment. DFE has a relatively low environmental toxicity and does not deplete the ozone layer, therefore is considered a more environmentally friendly alternative to older refrigerants like CFC-12 (dichlorodifluoromethane) because it has a lower global warming potential (GWP).
Chemical Structure of 1,1-difluoroethane (DFE)
Drawn by Kevin G. Shanks (2025)
The pharmacology of DFE is primarily related to its toxicological effects, as it is not used for any therapeutic or medical application. It is often misused by individuals seeking to experience a high through inhalation, sometimes called “huffing”, which can be highly dangerous and lead to severe health consequences. The substance acts as a volatile anesthetic that depresses the central nervous system leading to a sedative effect via the GABAA and glutamate receptors. Symptoms of acute exposure to DFE are coughing, wheezing, difficulty breathing, drowsiness, dizziness, light-headedness, headache, nausea, euphoria, and loss of coordination. In more severe cases, it can cause slurred speech, altered judgement, unconsciousness, pulmonary edema, suffocation, and death. Chronic exposure to DFE may lead to more long-term effects, including potential neurological damage and heart damage, including coronary disease, angina, and arrhythmias, and potential psychological addiction.
Electronic cleaning spray with DFE as an ingredient Images by Kevin G. Shanks (2025)
There have been several case reports of DFE toxicity and fatality published in scientific literature over the years. In reports published by Broussard et al. and Hahn et al., 3 adults died in vehicle accidents and had blood DFE levels ranging from 35-86 mcg/mL. In another report published by Frazee et al., two men were found dead after using DFE – they had postmortem blood DFE concentrations of 61 and 230 mcg/mL. In another report published by Vance et al., 14 adults who died following acute ingestion of DFE had postmortem blood concentrations ranging from 3-380 mcg/mL.
As DFE is not a pharmaceutical medication or substance approved for use in the human body, there is no amount considered safe for use, therefore, there is also no unequivocal corresponding postmortem blood concentration that is considered therapeutic, toxic, or fatal. All postmortem blood concentrations can and should be considered relevant in a medical-legal investigation surrounding impairment, toxicity, and/or fatality.
Axis Forensic Toxicology tests for DFE by gas chromatography with flame ionization detection (GC-FID) under order code 46590, and has just added the screen to the Comprehensive Panel with Analyte Assurance™. Minimum sample size is 0.5 mL. Due to the previously mentioned lack of relevancy of postmortem blood concentrations, all results are reported as qualitative (positive or negative). No quantitation is performed.
As always, if you have questions about DFE and how it may have played a role in your medical-legal investigation, please reach out to our subject matter experts by email ([email protected]) or phone (317-759-4869, Option 3).
References
- Randall C. Baselt. Fluorocarbons. Disposition of Toxic Drugs and Chemicals in Man.12th Edition. Pages 878-880.
- Larry Brousard, Barry S. Levine, Sarah Kerrigan. Chapter 31. Inhalants. Principles of Forensic Toxicology. 5th Edition. Pages 561-568.
- L. Brousard, T. Brustowicz, T. Pittman et al. Two traffic fatalities related to the use of difluoroethane. Journal of Forensic Science, 42: 1186-1187 (1997).
- T. Hahn, J. Avella, and M. Lehrer. A motor vehicle accident fatality involving the inhalation of 1,1-difluoroethane. Journal of Analytical Toxicology, 30: 638-642 (2006).
- C.C. Frazee III, S. Fleming, and U. Garg et al. Huffing: Two deaths involving 1,1-difluoroethane. Society of Forensic Toxicologists Annual Meeting, 2010.
- C. Vance, C. Swalwell, and I. McIntyre. Deaths involving 1,1-difluoroethane at the San Diego County Medical Examiner’s Office. Journal of Analytical Toxicology, 36: 626-633 (2012).
Axis Adds 1,1-Difluoroethane to our Comprehensive Panel with Analyte Assurance™
We are excited to share some great news with you! Based on your valuable feedback and our ongoing efforts to improve our products, we are pleased to announce the addition of 1,1-Difluoroethane to our Comprehensive Panel with Analyte Assurance™, effective 3/10/2025.
Similar to other analytes included as part of Analyte Assurance™, if 1,1-Difluoroethane is noted as positive upon screening, our dedicated Lab Client Support team will contact you to determine if confirmation testing is desired.
At Axis Forensic Toxicology, we prioritize your needs and continuously work to improve our services to better meet your expectations. This new addition is a direct result of your input and our dedication to providing you with the most complete and reliable testing solutions.
If you have any questions or need further information about this update, please don’t hesitate to contact us at [email protected]. Our team is always ready to assist you.
Thank you for your continued trust and partnership. We look forward to delivering the highest quality service and testing solutions to support your needs.
Sincerely,
Matt Zollman
Director of Operations & Product Management
Axis Experts Present at AAFS, February 2025
In mid-February 2025, two Forensic Toxicologists from Axis, Stuart Kurtz and Laureen Marinetti, attended the American Academy of Forensic Sciences annual meeting. While there, Stuart presented Axis’s data on nitazenes and Laureen presented Axis’s data on drug screening in vitreous fluid. For additional information please use this link to access previous Axis blog posts regarding nitazenes: https://axisfortox.com/?s=nitazene&post_type=post
As a refresher, nitazenes emerged after the scheduling of fentanyl analogs. This has largely lead to a decrease in new fentanyl analogs found in drug supplies but the rise in other opioids to fill their place. Isotonitazene was the first of these to emerge in 2019 with metonitazene emerging soon after. These are two of the original compounds described in drug patents from their initial clinical investigation. No nitazene compounds were ever approved for human or veterinary use. Nitazene compounds are structurally distinct from fentanyl analogs and morphine-based opioids such as morphine, hydrocodone, and oxycodone. This means that they will not cross-react in techniques that are immunoassay based. N-Pyrrolidino derivatives have emerged since 2023 which were not a part of the originally described compounds in the drug patents. A list of nitazene analogs that Axis can test for can be found in the Comprehensive Panel Specification Sheet here: https://axisfortox.com/test_catalog/comprehensive-drug-panel/
Graph by Stuart Kurtz
Above is a figure from Stuart’s poster that shows the trend of nitazenes by year. In 2024, metonitazene, N-pyrrolidino protonitazene, and N-pyrrolidino metonitazene are the top three by detections. Often times, two or three of these compounds will be detected together. Stuart will be expanding this data set for a presentation at the Midwest Association of Toxicology and Therapeutic Drug Monitoring in April 2025.
Vitreous fluid is located in the eye between the retina and the lens. It is made up of mostly water with trace amounts of inorganic salts, ascorbic and hyaluronic acids. Laureen’s presentation looked at the utility of screening for drugs using vitreous fluid and how this data compared to the same drug screening in blood. The data was from over 120 cases tested by Axis in the normal course of business wherein both blood and vitreous fluid were screened. The table below shows the drug class, the number of drug detections where the drug confirmed in blood in that drug class, and the percentage of time that the drug also confirmed in the vitreous fluid from the same case.
Chart by Laureen Marinetti, PhD
As shown in this table, all drugs did not confirm the same in each class. Drug entry into the vitreous fluid is dependent upon several factors; drug potency, time of death in relation to drug consumption, the chemical and pharmacological properties of the drug, drug volume of distribution, protein binding of the drug, and the drugs ability to cross the blood retinal barrier (BRB). Drugs may diffuse passively or be actively transported across the BRB. Although there are some advantages to testing vitreous fluid, for example it is isolated from blood and other tissues, it is less susceptible to postmortem redistribution and putrefactive changes, vitreous fluid is not a good specimen for general drug screening. Vitreous fluid is a great matrix for testing for electrolytes, glucose, urea nitrogen, creatinine and volatiles.
For more details on both the nitazenes poster and the vitreous fluid presentation, please reach out to us at 317-759-4869 option 3 or [email protected].
Read MoreLimitations of the Use of Reference Ranges to Interpret Toxicology Results in a Medicolegal Death Investigation
By Laureen Marinetti, PhD, F-ABFT
A therapeutic reference range like those listed on the Axis Forensic Toxicology report (Schulz, M., et al.) is provided as a starting point. These ranges are derived from the clinical literature regarding an effective range of therapy for a drug, a therapeutic range. Since they are from clinical data they are commonly measured in plasma or serum and collected from healthy subjects in a controlled study. These subjects are not infants, children, elderly or individuals in poor health or who abuse drugs. The samples are not whole blood and are not collected from the heart or a central cavity and they are not decomposed or from an embalmed body. Changes to drug levels after death are inevitable and unavoidable. Therefore, trying to compare postmortem concentrations to these clinical data is not comparing apples to apples so to speak. This is why any value given for a therapeutic, toxic, or lethal blood concentration is not considered absolute, but is to be used as a frame of reference or guideline in evaluating a specific case in its context.
What about postmortem data from case studies that provide toxic and lethal ranges? While a reference text such as Baselt is useful in a general sense, these data are not controlled for the many variables inherent in postmortem toxicology. These variables may include; collection site of the blood (concentrations from central sites may be affected by postmortem redistribution or PMR), the presence of other drugs (may add to or subtract from the toxic effects), tolerance state of the decedent, bacterial activity, genetic polymorphisms, resuscitation efforts, condition of the blood (decomposed or embalmed may lead to a lower concentration than at the time of death), manner of death (suicide vs accidental, the former potentially having an “overkill” drug concentration due to the intent of drug use), survival time (allows for drug metabolism thus lowering the postmortem measured concentration), and time of testing in relation to the sample collection (unstable drugs may degrade before they are tested, especially if the sample is not stored properly). Therefore, to help answer the million-dollar question; is the concentration and/or combination of drug(s) measured or detected significant to the cause of death, or is it an incidental finding.
The Academy Standards Board (ASB) developed a guideline for Forensic Toxicologists called Guidelines for Opinions and Testimony in Forensic Toxicology, ANSI/ASB 037. It states in part that opinions be based on the totality of information available, including case history, observations, circumstances, and other relevant information, and not based solely on analytical results (4.3.c). To follow the guidelines, the Forensic Toxicologist requires more information such as medical history, autopsy results, and death investigation. Having this information allows the toxicology results to be put in context of the specific case, thus giving the best answer to the question posed. Blood drug concentration and drug effects can be affected by the dose of the substance used, length of time between the dose and death, drug metabolism, drug absorption differences, route of administration, how long the drug has been used (tolerance), did the subject stop using the drug and then start again (loss of tolerance), age and sex of the individual, underlying pathology or observed disease states, individual drug stability in blood, postmortem redistribution or PMR (collect a peripheral blood to help minimize PMR), protein binding, and the accumulation of active metabolites. There is also the first Academy Standards Board standard for Medicolegal Death Investigation entitled, Organizational and Foundational Standard for Medicolegal Death Investigation, ANSI/ASB 125 First Edition, 2021.
Let’s look at some specific drugs and case histories to illustrate the difficulty with the interpretation of toxicology findings. These examples are nowhere near all inclusive.
Examples of two drugs that need to be interpreted in context are fentanyl and ketamine. Both of these drugs are commonly used medically therefore if a decedent is in the hospital or had emergency treatment prior to death, it would be important to have medical records, especially if the case is a suspected drug overdose. Tolerance or lack of tolerance is one, but not the only, important variable to consider. Two drugs that result in high tolerance are methadone and fentanyl. During the time of methadone clinics for heroin treatment, methadone concentrations in tolerant subjects were documented up to 3000 ng/mL, range of 30 to 3000, and ranged from 20 to 2000 in impaired drivers. Blood concentrations found in the postmortem blood of people who died from methadone toxicity ranged from 60 to 3100 ng/mL. These large, overlapping ranges can possibly be explained by tolerance, but PMR and the presence of other central nervous system (CNS) depressant drugs can also play a role. Also, underlying disease can result in a subject being more sensitive to a drug’s toxic effects. Methadone is cardio-toxic therefore those with cardiac disease may be more sensitive to methadone toxicity than those that do not have cardiac disease.
Fentanyl was predominately used in a medical setting; the first abuse of fentanyl was diversion of the medical product. In that time a fentanyl therapeutic range from clinical data was 0.3 to 3.8 ng/mL, therefore a value of 8 ng/mL or more was thought to be a possible cause or at least contributory to death. However since the mass abuse of the illicitly manufactured fentanyl, the concentration of fentanyl in ante-mortem toxicology case work has been increasing. Driving under the influence of drugs data is a great way to gain an appreciation of tolerance in the user population. In a study of 186 living subjects from driving under the influence of drugs case work, showed fentanyl concentrations ranging from 0.5 to 303 ng/mL, with a mean of 11.8 and median of 5.5 ng/mL (hospital records were reviewed to exclude those cases in which fentanyl was administered). In this same study there were 238 central blood samples from postmortem cases where fentanyl was listed in the COD which showed a range of 0.7 to 636 ng/mL with a mean of 32.5 and a median of 19.3, and 58 peripheral blood samples from postmortem cases which showed a range of 0.9 to 78 ng/mL with a mean of 14 and a median of 10. As shown by this data, fatal and impairing concentrations of fentanyl overlap and the clinical therapeutic range determined years ago no longer applies to most fentanyl cases today. A review of the autopsy and investigation findings is important for fentanyl positive cases.
For those decedents with a history of respiratory conditions, opioids like fentanyl and other drugs that cause central nervous system depression can be fatal at lower concentrations. Decedents with cardiovascular or hypertensive disease are more sensitive to the toxic effects of stimulant drugs like cocaine, methamphetamine, MDMA, pseudoephedrine, caffeine, etc. Drugs whose toxic effects include seizures can lower the threshold of toxicity if the decedent already has a seizure disorder. While the drug may not be the direct cause of death, it may be contributory to the death in combination with the underlying disease state. There are many variables to consider in each case and there is no one size fits all type of reference range for forensic toxicology testing nor should there be. The interpretation hinges on the context and circumstances of the specific case. Axis Forensic Toxicology understands that one should never practice toxicology strictly by the numbers and we are able to help with interpretation of the toxicology results in your case work. If you have any questions or concerns regarding a substance’s role in your medicolegal death investigation, please reach out to our subject matter experts at [email protected].
“All things are poisons, for there is nothing without poisonous qualities. It is only the dose which makes a thing poison.” (Paracelsus).
References
- ANSI/ASB 037, Guidelines for Opinions and Testimony in Forensic Toxicology, 2019. https://www.aafs.org/asb-standard/guidelines-opinions-and-testimony-forensic-toxicology
- ANSI/ASB 125, Organizational and Foundational Standard for Medicolegal Death Investigation, 2021. https://www.aafs.org/asb-standard/organizational-and-foundational-standard-medicolegal-death-investigation
- Baselt, Randall C., Disposition of Toxic Drugs and Chemicals in Man, 12th Edition, Biomedical Publications, 2020.
- Havro, V., Casassa, N., Andera, K., and Mata, D., A Two-Year Review of Fentanyl in Driving under the Influence and Postmortem Cases in Orange County, CA, USA., Journal of Analytical Toxicology, Vol. 46, Issue 8, October 2022, pp. 875-881.
- Rohrig, Timothy P., Postmortem Toxicology Challenges and Interpretive Considerations, Elsevier Academic Press, 2019.
- Schulz, M., Iwersen-Bergmann, S.,Andresen, H.,and Schmoldt, A. Therapeutic and toxic blood concentrations of nearly 1,000 drugs and other xenobiotics, Critical Care, 2012, 16:R136.
- Stephenson, L., Van Den Heuvel, C., Scott, T., and Byard, R.W., Difficulties Associated with the Interpretation of Postmortem Toxicology, Journal of Analytical Toxicology, Vol. 48, Issue 6, July 2024, pp. 405-412.
Axis Offers Training Opportunities for Forensic Pathology Medicine Fellows
By Kevin G. Shanks, M.S., D-ABFT-FT
Axis Forensic Toxicology prides itself in its ability and willingness to provide continuing education and training for our forensic toxicology clients. One of these educational avenues is the Axis forensic medicine fellow training rotation program. We are planning now for our Spring 2025 program.
In this weeklong virtual training program, a Forensic Medicine Fellow will be introduced to the set-up and operation of the modern postmortem forensic toxicology laboratory, alongside descriptions of the analytical instrumentation and analytical methods employed by the laboratory. Board certified forensic toxicologists will discuss the importance of toxicology specimen collection and present a survey of the major illicit and pharmaceutical drugs (e.g. ethanol, cocaine, methamphetamine, MDMA, heroin, fentanyl, and prescription opioids) with respect to mechanisms of actions, their detection, and their relevance to cause of death determination. Novel psychoactive substances (NPS), to include designer benzodiazepines, synthetic cannabinoids, substituted cathinones, fentanyl analogs, nitazene derivatives, xylazine, and mitragynine (kratom) are also discussed in depth.
The forensic toxicology forensic medicine fellow training rotation instills the Fellow with confidence in interpreting the significance of toxicological findings with respect to cause and manner of death classification. Peer reviewed scientific references provided to the Fellow lay a foundation for a body of knowledge that may aid in the resolution of drug-related deaths by the forensic pathologist. One-on-one toxicology case review with a forensic toxicologist surveying completed cases by the laboratory will be undertaken and is intended to give the Fellow an overview of how a “toxicology pending conference” is conducted between forensic pathologists and forensic toxicologists.
If you are a forensic pathology fellow or a pathologist who directs forensic pathology fellows and are interested in learning more about this training opportunity, please reach out to Axis Forensic Toxicology’s toxicologists at [email protected] or call us on the phone at (317) 759 – 4869.
Read MorePoster Presentation: An Analysis of Drug Detections in Carfentanil Cases from 2020-2024
By Stuart Kurtz, D-ABFT-FT
This year at the annual meeting for the Society of Forensic Toxicologists (SOFT), we presented data looking at the detections of other drugs in cases with carfentanil detected. This was a continuation of data presented at the Midwest Association of Toxicology and Therapeutic Drug Monitoring (MATT) annual meeting earlier this year. The presentation at MATT focused on where the cases were and how many we were seeing over time. This post can be found at the link below.
https://axisfortox.com/carfentanil-through-the-years-a-look-at-data-from-2016-2024/
During the Q&A portion of that presentation, I was asked if carfentanil is seen by itself or is it usually with other drugs. That prompted the creation of the SOFT presentation. I expanded the number of detections graph to include 2024 through the end of September. We have had 82 detections of carfentanil during that time period. Kentucky (42) and Indiana (21) have the highest number of detections with no other state having more than 5 during the same time period.
Figure 1: Number of detections of carfentanil in casework from 2016 through September 30, 2024. The table below the graph expresses the detections of carfentanil as a percentage of total cases tested for the same time period. Carfentanil was added to our 70510: Comprehensive Panel, Blood in 2020 and is screened in cases where this panel is ordered.
In Figure 1, 2021 and 2022 had very few detections of carfentanil. This could be used to justify the removal of carfentanil from testing. The increase of cases starting in mid-2023 shows that caution should be taken when considering this. There is no guarantee that other novel psychoactive substances (NPS) will follow this pattern. NPS can have a cyclical nature to them where they may come and go from the drug supply over a period of years. If a lab validates a method to test for an NPS, they should consider keeping it as part of their testing scope even if the number of detections drops to 0 for an extended period of time.
In cases where carfentanil was detected with xylazine (5), bromazolam (6), and fluorofentanyl (22), fentanyl was detected in all of those cases. Overall, carfentanil and fentanyl were detected in 153 cases. Carfentanil was detected in 79 cases without fentanyl. The top detections in those cases were 4ANPP (20), cocaine as benzoylecgonine (11), methamphetamine (11), and acetylfentanyl (9). 7 of the 247 cases since 2020 had carfentanil as the only drug of interest. While this is a small number, the circumstances of those cases may not account for cause of death (COD) without knowing carfentanil is present.
Even though carfentanil is rarely the only drug of interest, it may help to explain COD. A history of use of drugs like heroin, methamphetamine, or fentanyl may indicate a high tolerance. Toxicology results with low to moderate amounts may not give a clear indication of COD but the presence of a drug like carfentanil, with its high potency, may tie it all together. Carfentanil is available with Analyte Assurance™ as part of the 70510: Comprehensive Panel, Blood and as a directed test in the 13810: Designer Opioids Panel, Blood. Awareness of seized drugs in a jurisdiction is a huge help in determining whether a seemingly negative toxicology report needs an additional look.
If you have any questions about this presentation, need help with the interpretation of results, or want to request a copy of the poster, please contact us at [email protected] or 317-759-4869 option 3.
Read MoreAxis Forensic Toxicology Announcement: Dr. Laureen Marinetti Appointed to Medicolegal Death Investigation Consensus Body
Axis Forensic Toxicology is pleased to announce that our Chief Toxicologist, Dr. Laureen Marinetti, has been appointed to the Medicolegal Death Investigation Consensus Body under the American Academy of Forensic Sciences’ Academy Standards Board (ASB). This appointment reflects Dr. Marinetti’s dedication to advancing forensic toxicology and her commitment to enhancing the standards and practices in the field.
The Medicolegal Death Investigation Consensus Body is a key component of the ASB, focused on developing, approving, and enforcing recognized standards in forensic science. These standards play a critical role in ensuring accuracy, reliability, and integrity in death investigations.
Dr. Marinetti brings a wealth of experience and expertise to this important group. With over two decades of leadership in forensic toxicology, she has been instrumental in addressing emerging trends, advancing methodologies, and contributing to public health and safety. Her role at Axis has consistently underscored the importance of scientific rigor and collaboration in forensic investigations.
At Axis, we are proud to support professionals like Dr. Marinetti, who contribute to the development of best practices across the forensic community. Her appointment to the Medicolegal Death Investigation Consensus Body highlights her contributions to the field and Axis’ ongoing commitment to supporting advancements in forensic science.
Please join us in congratulating Dr. Laureen Marinetti on this significant achievement. Her work with the Consensus Body will help shape the future of medicolegal death investigations and further strengthen the standards that serve our communities.
For more information about Dr. Marinetti’s work and Axis Forensic Toxicology’s services, visit http://axisfortox.com.
About Axis Forensic Toxicology
Axis Forensic Toxicology is a leading provider of comprehensive toxicology services, specializing in postmortem, criminal, and clinical testing. With a commitment to scientific excellence, accuracy, and timely reporting, Axis supports medical examiners, coroners, and law enforcement agencies across the country. Our state-of-the-art laboratory, highly trained professionals, and dedication to quality assurance ensure reliable results that meet the highest standards. At Axis, we are driven by innovation and collaboration, helping our clients address complex toxicological challenges and make informed decisions that protect public health and safety.
Unpacking the Truth Behind “Pink Cocaine”
By Kevin Shanks, D-ABFT-FT
“Pink cocaine” has been in the news recently due to the death of Liam Payne, one of the vocalists from the pop music group, One Direction. He died after falling from the balcony of his hotel room in Buenos Aires, Argentina.
What exactly is “pink cocaine”?
It is literally just a bunch of drugs rolled into one powdery concoction and dyed the color pink. Drugs in “pink cocaine” may include ketamine, MDMA, methamphetamine, caffeine, or other novel psychoactive substances (NPS). And even though the name suggests it, “pink cocaine” most likely does not contain cocaine. Because of the lack of uniformity in illicit drugs, “pink cocaine” may differ in its makeup over time, from batch to batch. The mixture also goes by the name “tusi”, which may lead some people to believe that it may contain substituted/psychedelic phenethylamines such as 2C-B or 2C-I (which were originally synthesized by neuropharmacologist Alexander Shulgin), even though this has not been a reported as a regular constituent of the drug. According to the United States Drug Enforcement Administration (DEA), since 2020, they have seized a total of 960 pink powders. Four exhibits contained 2C-B and the other 956 contained other substances. And even though 2C-B has been detected in a few “pink cocaine”-related powders, Shulgin did not invent “pink cocaine” which has been previously erroneously reported by various media and news agencies.
Photograph of Pink Cocaine. DEA. https://www.dea.gov/pink-cocaine
The effects of “pink cocaine” are unpredictable due to the unknown nature of what specific substances are making up the concoction at the time of use. If it contains a dissociative anesthetic such as ketamine, the pharmacological effects may include sedation, dissociation, hallucinations, and delusions. If it contains a stimulant such as methamphetamine or MDMA, the effects may include tachycardia, hypertension, hyperthermia, and agitation. But again, the observed effects will be completely dependent on what specific substances are actually in the “pink cocaine” product.
Why is it dyed the color pink?
Most likely, the answer is to make it more memorable. Drug products are often dyed different colors to bring attention to them or to act as a branding mechanism. Bright colors are visually appealing and are often seen in the manufacturing of Ecstasy tablets. Brightly colored tablets of fentanyl, also known as rainbow fentanyl, were also a thing reported in the media a couple of years ago.
Liam Payne’s death was originally reported as being “pink cocaine”-related, but in November, officials in Argentina reported that the postmortem toxicology showed “traces of alcohol, cocaine, and a prescribed antidepressant”. He had used real cocaine, not “pink cocaine”.
In an unrelated story, “pink cocaine” has also been associated with the sexual assault and trafficking lawsuits involving rapper, record producer, and studio executive Sean “Diddy” Combs. Parts of the lawsuits claim that Diddy required employees to carry around “pink cocaine”, as well as other drugs, at all times for personal use.
Axis monitors for the compounds found in “pink cocaine”, as part of our Comprehensive Panel (order code 70510) with Analyte Assurance™. Screening is completed by liquid chromatography with quadrupole time of flight mass spectrometry (LC-QToF/MS) and confirmatory analyses are completed using liquid chromatography with triple quadrupole mass spectrometry (LC-MS/MS).
As always, if you have questions about “pink cocaine” or any other classical drug or NPS and how they may play a role in your medical-legal investigation, please reach out to our subject matter experts by email ([email protected]) or phone (317-759-4869, Option 3).
References
Liam Payne reportedly had ‘pink cocaine’ in his system when he died. NBC News. Hannah Peart. October 22, 2024. https://www.nbcnews.com/news/world/liam-payne-death-one-direction-pink-cocaine-toxicology-report-rcna176532
Tusi: a new ketamine concoction complicating the drug landscape. J.J. Palamar. Am J Drug Alcohol Abuse. September 2023. DOI: 10.1080/00952990.2023.2207716.
Pink Cocaine. United States Drug Enforcement Administration. https://www.dea.gov/pink-cocaine
Argentine prosecutors charge 3 people linked to the death of former One Direction star Liam Payne. AP News. Almudena Calatrava. November 8, 2024. https://apnews.com/article/argentina-payne-death-charged-e73f589a37a4a8f0e80e0b0e71d0f0f4
Diddy allegedly forced employees to carry pink cocaine at all times. VICE. Sammi Caramela. October 24, 2024. https://www.vice.com/en/article/diddy-pink-cocaine/
Read MorePoster Presentation: Not Your Typical TCA: A Review of Cases Involving Tianeptine
By Stuart Kurtz, D-ABFT-FT
At this year’s annual meeting of NAME, we presented a handful of case reports on tianeptine. We had previously provided some information on tianeptine in a blog post from September 18, 2023. The aim of this poster was to present cases where we detected tianeptine as the primary drug of interest. There were only 2 cases out of 6 presented where this was the case. One of these cases from District 14 Florida had contributing factors of acute pneumonia, chronic pancreatitis, and hepatic steatosis. The other case from Missouri had alcohol as a contributing factor.
Initially, there was a third case that looked to be a tianeptine only fatality. Additional testing by the Lorain County OH crime lab revealed that 2 opened bottles of Neptune’s Fix Tianeptine Elixir found at the scene contained ADB-4en-PINACA and MDMB-4en-PINACA which are synthetic cannabinoids. Using this information, we were able to test the submitted specimens for these drugs via our 42130: Synthetic Cannabinoids panel and confirm the presence of both in the blood.
Due to the current gray area surrounding the sale of products containing tianeptine, scene evidence can be extremely useful. Tianeptine is screened in Axis’ 70510: Comprehensive Panel with Analyte Assurance™ in Blood and confirmed through the 13710: Novel Emerging Compounds Panel but may not be a part of routine screening in all labs. Awareness of what the lab is testing for is important when scene evidence indicates a particular drug. Labeled products can also be tested due to the inconsistent nature of the manufacturing of these products. In the above case from Lorain County OH, additional testing revealed that there were other drugs involved. Product labels are a good starting point but further testing is important to ensure that all factors can be accounted for. The FDA has urged manufacturers of Neptune’s Fix Tianeptine Elixir to recall all products and as of February 2024, all of them have done so.
We would like to thank the following offices for their contribution to this project.
- Office of the District Medical Examiner, District 15 FL, Dr. Terrell Tops & Dr. Natalia Belova
- Office of the District Medical Examiner, District 14 FL, Whit Majors & Dr. Jay Radtke
- Office of the Coroner, Lorain County, OH, Dr. Frank P. Miller
- Southwest Missouri Forensics, Nixa, MO, Carla Yoder & Dr. Ransom Ellis
If you have any questions about this post or want to request a copy of the poster, please reach out to us at 317-759-4869 option 3 or [email protected].
Read MoreAxis Experts Present, Fall 2024
By Denise Purdie Andrews
This Fall, Axis’ expert toxicologists can be found speaking in multiple venues, helping to educate our clients and share expertise with other forensic scientists.
The National Association of Medical Examiner (NAME) 2024 Annual Meeting, which will be held in Denver, Colorado, from September 19-23.
- Toxicologist Stuart Kurtz will be presenting a poster on Saturday, September 21st: Not Your Typical TCA: A Review of Cases Involving Tianeptine.
- Laboratory Director Laureen Marinetti will make a platform presentation on Monday, September 23rd at 14:15 local time: Differentiating Emergent Ketamine from Illicit Abuse in Postmortem Cases.
- Axis’ CEO, Phil Roberts, will also be in attendance to answer your product and service questions.
The Society of Forensic Toxicology (SOFT) 2024 Conference will be held October 27 – November 1 in St. Louis, MO.
- Toxicologist Stuart Kurtz will present a poster, An Analysis of Drug Detections in Carfentanil Cases from 2020-2024.
- Laboratory Director Laureen Marinetti will present a poster, The Comparison of Whole Blood and Vitreous Fluid Drug Findings in Fifty Postmortem Cases.
Toxicologist Kevin Shanks has a forthcoming paper in the Journal of Analytical Toxicology:
We will be sharing more information about the content of these presentations in the coming months. If you would like copies of any of the presentations, please email [email protected] and a copy will be provided after they have been presented. If you have the good fortune to attend one of these sessions, please connect with your Axis experts. We’d like to thank you for your business and ensure that we are continuing to serve you well!
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