CURRENT SECTION PRIORITIES

  1. Review CFS case data to evaluate and publish trends in the following areas.

    a. Alcohol and / or drug impaired driving.

    b. The role of drugs, other than alcohol, in fatal motor vehicle collisions.

    c. Investigations of individuals who have died while in custody and the death is opioid-related.

  2. Develop or expand data sets to inform interpretation of toxicological fidings in forensic casework.

Toxicology Project Proposals

Click on the detail below to see individual project details


Investigation of blood opioid concentrations in individuals suffering from severe chronic pain

DetailsProject Title:

Investigate opioid concentrations in individuals (e.g., cancer patients) experiencing severe chronic pain within a clinical or outpatient system. Particularly interested in the pediatric population (i.e., 18 years of age or less) and patients receiving hydromorphone.

Background:

Individuals who experience severe chronic pain are often prescribed opioid medications (e.g., morphine, oxycodone, methadone, hydromorphone, etc.) on a long-term basis in order to achieve pain control for better quality of life. However, the repeated use of opioids typically results in the development of tolerance whereby the individual requires increasingly larger doses to maintain an effective analgesic outcome. Studies of opioid concentrations in patients who chronically receive high doses are very limited. Opioid-tolerant individuals will exhibit serum opioid concentrations which could be toxic or lethal in naive users. The limited published literature on serum/blood opioid levels in living chronic opioid patients may lead to the forensic misinterpretation of post-mortem blood opioid concentrations.

Research Objective:

To document opioid concentrations in highly tolerant patients and thereby more accurately interpret post-mortem opioid blood concentrations in death investigations.

Partnership Opportunity:

To contribute to the medico-legal literature related to the opioid tolerance seen in patients receiving high doses of opioids while being treated for severe chronic pain.

Resources Required:
  • Access to individuals receiving high-dose opioids within a clinical or outpatient system and ability to collect whole blood samples using sterile technique.
  • Ability to collect limited, but relevant patient information (e.g. age, sex, opioids used, dosing, length of opioid therapy, etc.).
  • Review current literature and draft study design.
  • Prior publication experience is valuable but not required.
Resources Available:

The CFS will conduct all extractions & analyses using current standard operating procedures (i.e. LC-MS/MS).

Date PostedCFS Project LeadPartner AgencyAgency LeadStatus
23-05-2019Celeste OwenAvailable

Absorption of drugs by gel separator in plasma samples stored in gel separator tubes

Details

There have been a number of cases where post-mortem blood drug concentrations have been significantly higher than hospital plasma/serum drug concentrations in the absence of a significant survival time between collection of the hospital sample and death. In these cases, the plasma/serum samples have been collected in gel separator tubes. While the post-mortem blood drug concentration may be higher due to post-mortem redistribution, it may also be attributable to absorption of drugs by the gel separator. This study is intended to examine whether results from plasma/serum samples collected in gel separator tubes provide an accurate representation of the plasma/serum drug concentration at the time of sample collection. This is important for interpretations in forensic toxicology casework.

Date PostedCFS Project LeadPartner AgencyAgency LeadStatus
13-05-2020Cara Shepard & Liora BliumkinInternally-conducted researchnullAssigned

Review of Toxicology drug findings in sexual assault casework over a 5-year period

Details

data analysis project of toxicology findings in sexual assault cases for the last 5 years to develop a data set from sexual assault cases to help inform interpretation of toxicological findings in forensic casework.

Date PostedCFS Project LeadPartner AgencyAgency LeadStatus
29-09-2020Patricia SolbeckUTMDr. Karen WoodallAssigned

Drug use among Automobile drivers in Ontario - 2018 to 2020 data

DetailsProject Title:

Drug use among Automobile drivers in Ontario Background: Impaired driving is the leading criminal cause of death and injury in Canada, and drug-impaired driving is increasing

Research Objective:

To retrospectively examine Toxicology section case results to test the hypothesized that the number of drug-involved driver fatalities now rivals, and possibly exceeds, the number involving alcohol.

Partnership Opportunity:

Examine drug use among two populations of Ontario drivers – those fatally injured in motor vehicle collisions and those arrested and evaluated by a Drug Recognition Evaluator. Data from case files compiled by the Toxicology section of the Centre of Forensic Sciences from 2018 to 2020 will be analyzed to gain a better understanding of the types of drugs used by drivers, the demographic characteristics of those involved (e.g., age group, sex), and the circumstances of the event (e.g., month of occurrence, day of week, time of day). Comparisons of drug-involved driver fatalities with drug-driving arrests will outline similarities and differences in these two populations and provide insights into how enforcement activities might better target those drug drivers most likely to crash.

Resources Required:

Expertise evaluating and analysing data.

Resources Available:

Data is available from case records. Data will be anonymised prior to sharing with partner.

Date PostedCFS Project LeadPartner AgencyAgency LeadStatus
29-09-2020Dr. Amy PeaireCanadian Centre on Substance Use and AddictionDr. Douglas BeirnessAssigned

Impact of recreational cannabis legalization on traffic injury deaths in Ontario (2015 – 2020)

Details

The Cannabis Act came into effect on October 17 2018, which outlines a strict framework for controlling the sale, possession, production and distribution of cannabis in Canada. There remain concerns that recreational cannabis legalization may affect the perceived harmfulness of cannabis use.

Current evidence concerning the impact of recreational cannabis legalization on traffic injuries from jurisdictions in the United States is mixed (1-4). Importantly, the generalizability of this evidence to the context in Canada is limited, given the differences between the two countries in socio-legal environments.

Our research aim is to examine the impact of cannabis legalization on traffic injury deaths based on toxicological analyses of blood samples from 2015 to 2020. We anticipate using time series analysis methods with monthly or quarterly data.

Potential research questions include:

1. Does recreational cannabis legalization result in increases in rates of traffic injury deaths with detection of cannabis?

2. Does recreational cannabis legalization result in decreases in rates of traffic injury deaths with detection of alcohol?

3. Does recreational cannabis legalization result in decreases in rates of traffic injury deaths with detection of other drugs?

4. How have the rates of traffic injury deaths with detection of cannabis, alcohol and other drugs changed from the pre-recreational cannabis legalization period to the post-recreational cannabis legalization period for non-highway vehicles (e.g. ATVs, boats, bicycles?

5. Have demographic characteristics and collision characteristics of traffic injury deaths with detection of cannabis, alcohol and other drugs changed from the pre-recreational cannabis legalization period to the post-recreational cannabis legalization period?

Date PostedCFS Project LeadPartner AgencyAgency LeadStatus
06-12-2021Marina ChiaravallotiCentre for Addiction & Mental HealthDr. Robert MannAssigned

Development of a SQL database query tool to 'mine' Toxicology drug analysis results

Details
(Note: Details are null for this project)
Date PostedCFS Project LeadPartner AgencyAgency LeadStatus
27-01-2022Patricia SolbeckLaurentian UniversityDr. James Watterson & Maryam Refaat-FakhoriAssigned

Effects of drugs and alcohol on psychomotor and driving performance: A systematic review and meta-analysis

DetailsDetails content:

Systematic review of literature to develop tables of published data related to alcohols effect on psychomotor and driving performance and compare these effects to published data of other drugs.

Interpretation in forensic toxicology relies on the objective evaluation of literature related to a given question. For drug effects related to impairing an individual’s ability to operate a motor vehicle, this can typically be achieved by a review of the literature as it relates to clinical/laboratory effects of drugs, simulator or on-road driving studies and when available, epidemiological studies of prevalence and crash risk for drug classes. Meta-analysis of data allows for the compilation of multiple studies to increase the strength of an interpretive opinion. Further, collecting data from multiple studies and presenting it to answer a forensically relevant question may allow for the development of models that asses the relative strength of an opinion/conclusion in a given report (towards evaluative reporting).

Date PostedCFS Project LeadPartner AgencyAgency LeadStatus
27-01-2022Trevor BeaudoinAvailable