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A special issue of Toxics (ISSN 2305-6304). This special issue belongs to the section "Drugs Toxicity".

Deadline for manuscript submissions: 8 August 2026 | Viewed by 17049

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Special Issue Editors

Dr. Marek Wiergowski

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Guest Editor

Department of Forensic Medicine, Faculty of Medicine, Medical University of Gdansk, M. Skłodowskiej-Curie 3a, 80-210 Gdansk, Poland
Interests: forensic analytical chemistry; forensic toxicology; forensic alcohology; forensic sciences

Dr. Giuseppe Davide Albano

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Guest Editor

Section of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90129 Palermo, Italy
Interests: forensic pathology; forensic histopathology; forensic imaging; clinical forensic medicine

Dr. Claudia Trignano

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Guest Editor

Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
Interests: forensic toxicology; DUID; DFSA; forensic pathology; legal medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue aims to provide a comprehensive collection of research to advance our understanding of the complex interplay between drugs of abuse, alcohol, and their impact on populations. This Special Issue seeks to bring together cutting-edge research and expert insights addressing both current challenges and future directions in forensic toxicology.

Forensic toxicology is a critical field that intersects with clinical medicine, public health, and the justice system. As such, this Special Issue will provide a multifaceted exploration of the toxicological and forensic implications of substance abuse. Our focus spans a wide array of substances, with particular attention to the nuances of their effects on vulnerable groups such as children, adolescents, pregnant women, elderly individuals, and those with preexisting health conditions.

One of the core aims of this Special Issue is to highlight the clinical implications of drug and alcohol abuse. Papers will explore the physiological and psychological impacts of substance use, examining how chronic use alters biological systems and contributes to comorbid conditions. We are particularly interested in research that explores novel biomarkers for the early detection and monitoring of substance abuse, as well as innovative therapeutic approaches for managing addiction and its health consequences.

From a toxicological perspective, this Special Issue will feature studies on the detection and quantification of drugs and alcohol in biological matrices. Advances in analytical techniques, such as mass spectrometry and high-performance liquid chromatography, will be showcased, emphasizing their role in improving accuracy and sensitivity in forensic investigations. Research that addresses the challenges of interpreting toxicological data in the context of postmortem examinations and legal proceedings is also highly encouraged.

The forensic implications of substance abuse are vast and multifaceted. Contributions to this Special Issue will explore the legal ramifications of drug and alcohol use, including impaired driving, drug-facilitated crimes, and workplace substance abuse. Papers will examine how forensic toxicologists contribute to legal processes by providing expert testimony and supporting law enforcement with reliable evidence.

Given the dynamic nature of substance abuse trends, this Special Issue will also look ahead to emerging substances of concern. Research on novel psychoactive substances (NPSs), synthetic opioids, and other rapidly evolving drug markets will be featured, highlighting the need for adaptive forensic strategies and updated regulatory frameworks.

In summary, this Special Issue of Toxics on forensic toxicology research aims to provide a comprehensive resource that addresses the current issues and future research perspectives on drugs of abuse and alcohol. By focusing on clinical, toxicological, and forensic implications, we hope to foster a deeper understanding and spur further innovation in this critical field. We invite researchers, clinicians, and forensic professionals to contribute their findings and insights, helping to shape the future of forensic toxicology. Studies may include, but are not limited to, the following:

Postmortem forensic toxicology;
Synthetic and natural poisons;
The interpretation of forensic toxicological data;
The screening of medicines, drugs of abuse, and alcohol in clinical and forensic specimens;
Human performance toxicology;
Driving under the influence of drugs and alcohol;
Workplace drug testing;
The application of proteomics to forensic toxicology;
Markers for neurochemical diagnostics;
Prenatal alcohol exposure and related biomarkers.

Dr. Marek Wiergowski
Dr. Giuseppe Davide Davide Albano
Dr. Claudia Trignano
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Toxics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

forensic toxicology
forensic analytical chemistry
postmortem toxicology
drugs of abuse detection
forensic alcohology
drug-impaired driving
forensic biochemistry
nanochemistry biomarkers

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Published Papers (7 papers)

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Research

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23 pages, 2467 KB

Open AccessArticle

by Ahmed I. Al-Asmari, Atheer Zarnoogi, Hassan Alharbi, Ahmed Alghamdi, Faiz Alsolami, Abulnasser E. Alzahrani, Sultan A. Alahmadi, Naif H. Alotaibi, Khaled A. Alboug, Mansour A. Alzahrani and Torki A. Zughaibi

Toxics 2026, 14(4), 308; https://doi.org/10.3390/toxics14040308 - 3 Apr 2026

Viewed by 896

Abstract

Although alcohol consumption is prohibited in Saudi Arabia, methanol poisoning outbreaks continue to occur, largely through surrogate or non-beverage alcohols. To date, systematic forensic documentation of methanol-related fatalities in Saudi Arabia remains limited. This study presents a comprehensive post-mortem series of methanol-related deaths investigated in Jeddah and characterizes the demographic patterns, circumstances of death, post-mortem interval (PMI), and methanol distribution across multiple biological matrices. In total, 34 post-mortem cases with toxicologically confirmed methanol exposure were retrospectively examined. Methanol and ethanol levels in blood, urine, vitreous humor, bile, gastric contents, and selected tissues were quantified using a validated headspace gas chromatography–flame ionization detection method. Decedents were aged 18–73 years (median, 34.5 years), with a marked predominance of young-to-middle-aged men. PMI ranged 1–15 days (median, 2 days), and evidence of putrefaction was present in approximately one-third of the cases. Most deaths were classified as accidental and primarily occurred in private residences. Two distinct outbreak periods (2018 and 2022) were identified; values tended to be higher in 2018, but the differences were not statistically significant. NaF-preserved blood, urine, and vitreous humor were informative in non-decomposed cases, whereas vitreous humor and solid organs, particularly the liver and kidneys, retained quantifiable methanol in putrefied bodies. Ethanol was detected in a minority of cases and was considered a secondary or contributory finding. This study provides an important forensic baseline dataset for methanol-related fatalities in Saudi Arabia and underscores the need for continued surveillance and preventive measures. Full article

(This article belongs to the Special Issue Current Issues and Research Perspectives in Forensic Toxicology)

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13 pages, 448 KB

Open AccessArticle

Analysis of the Prevalence of Alcohol and Psychoactive Substances Among Drivers in the Material from the Department of Forensic Medicine at the Medical University of Bialystok in Poland

by Michal Szeremeta, Julia Janica, Gabriela Jurkiewicz, Marta Galicka, Julia Koścień, Julia Więcko, Jakub Perkowski, Michal Krzysztof Jeleniewski, Karol Siemieniuk and Anna Niemcunowicz-Janica

Toxics 2025, 13(11), 960; https://doi.org/10.3390/toxics13110960 - 6 Nov 2025

Viewed by 1629

Abstract

In recent years, the issue of drivers under the influence of medications and psychoactive substances as a cause of road accidents has gained increasing importance. This study aimed to assess the prevalence and blood concentration ranges of alcohol and psychoactive substances among drivers in northeastern Poland between 2013 and 2024. To determine the prevalence of medications and psychoactive substances in drivers’ blood, data were collected from 266 blood samples obtained from drivers (251 men and 15 women). Among these, 79 drivers died immediately, 61 drivers survived the accident, and 126 drivers were stopped for roadside checks. The presence of the studied substances was confirmed using gas chromatography combined with mass spectrometry detection (GC-MS) and liquid chromatography combined with mass spectrometry detection (LC-MS). Blood alcohol content was measured using headspace gas chromatography with a flame ionisation detector (HS-GC-FID). Psychoactive substances were detected in 152 of the 266 samples. Drivers testing positive for medications and psychoactive substances were most frequently stopped during roadside controls—67.46%. Among the total positive cases, psychoactive substances used alone or in combination included THC—46.3% (range 0.2–20 ng/mL), alcohol—26.8% (range 0.1–4.1‰), amphetamines—20.7% (range 15–2997 ng/mL), opiates—4.3% (morphine 66.0 ng/mL; methadone 174.0 ng/mL; ranges: tramadol 15.0–600.0 ng/mL; fentanyl 45.0–100.0 ng/mL), benzodiazepines—9.8% (ranges: diazepam 55.0–480.0 ng/mL; midazolam 17.0–1200.0 ng/mL; clonazepam 21.0–36.0 ng/mL), stimulants—6.10% (ranges: amphetamine 15.0–2997.0 ng/mL; cocaine 4.0–30.0 ng/mL; benzoylecgonine 38.0–602.0 ng/mL; PMMA 45.0–360.0 ng/mL; MDMA 20.0–75.0 ng/mL; mephedrone 37.5 ng/mL; alfa-PVP 120 ng/mL), psychotropic drugs—3.1% (carbamazepine 8.0–2100.0 ng/mL; zolpidem 233.0 ng/mL; citalopram 320.0 ng/mL; opipramol 220 ng/mL). The most commonly used substance among car and motorcycle drivers was THC (37.7% of car drivers and 60% of motorcyclists). Among operators of other types of vehicles, alcohol was the most frequently detected substance, present in 35% of cases. The majority of drivers (81.1%) were under the influence of a single substance. Among the drivers, 7.3% consumed alcohol in combination with at least one other substance, and 11.6% used two or more substances excluding alcohol. Among the psychoactive substances most frequently used alone or in combination with others, THC was predominant. Roadside testing, based on effects similar to alcohol intoxication, was mainly conducted on male drivers. Full article

(This article belongs to the Special Issue Current Issues and Research Perspectives in Forensic Toxicology)

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20 pages, 1258 KB

Open AccessArticle

The Crime of Vehicular Homicide in Italy: Trends in Alcohol and Drug Use in Fatal Road Accidents in Lazio Region from 2018 to 2024

by Francesca Vernich, Leonardo Romani, Federico Mineo, Giulio Mannocchi, Lucrezia Stefani, Margherita Pallocci, Luigi Tonino Marsella, Michele Treglia and Roberta Tittarelli

Toxics 2025, 13(7), 607; https://doi.org/10.3390/toxics13070607 - 19 Jul 2025

Viewed by 3642

Abstract

In Italy, the law on road homicide (Law no. 41/2016) introduced specific provisions for drivers who cause severe injuries or death to a person due to the violation of the Highway Code. The use of alcohol or drugs while driving constitutes an aggravating circumstance of the offence and provides for a tightening of penalties. Our study aims to report on the analysis performed on blood samples collected between January 2018 and December 2024 from drivers convicted of road homicide and who tested positive for alcohol and/or drugs. The majority of the involved subjects were males belonging to the 18–30 and 41–50 age groups. Alcohol, cocaine and cannabinoids were the most detected substances and the most frequent polydrug combination was alcohol and cocaine. We also investigated other influencing factors in road traffic accidents as the day of the week and the time of the day in which fatal road traffic accident occurred, and the time elapsed between the road accident and the collection of biological samples. Our data, in line with the international scenario, strongly support that, in addition to the tightening of penalties, raising awareness plays a key role in preventing alcohol- and drug-related traffic accidents by increasing risk perception and encouraging safer driving behaviors. Full article

(This article belongs to the Special Issue Current Issues and Research Perspectives in Forensic Toxicology)

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15 pages, 4911 KB

Open AccessArticle

TD-ESI-MS/MS for High-Throughput Screening of 13 Common Drugs and 4 Etomidate Analogs in Hair: Method Validation and Forensic Applications

by Meng Li, Jinbo Li and Binling Zhu

Toxics 2025, 13(5), 329; https://doi.org/10.3390/toxics13050329 - 23 Apr 2025

Viewed by 2357

Abstract

This study established a dual analytical workflow integrating thermal desorption–electrospray ionization–tandem mass spectrometry (TD-ESI-MS/MS) for rapid qualitative screening and ultra-performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) for confirmatory quantification of 17 psychoactive substances and metabolites across six classes (opioids, amphetamine-type stimulants, cocaine, ketamine-type drugs, cannabinoids, and etomidate analogs) in hair matrices. Validation of the TD-ESI-MS/MS method demonstrated its sensitivity (limits of detection: 0.1–0.2 ng/mg) and precision (<19.3%), with matrix effects controlled to <19.6%. The TD-ESI-MS/MS method achieved an analysis time of 1 min per sample, enabling high-throughput screening with a sensitivity >85.7% and a specificity >89.7% for the 17 analytes. UPLC-MS/MS confirmation validated the screening results with accuracy rates of 89.7–99.8%. An analysis of specimens confirmed positive identified etomidate analogs as the predominant psychoactive substances (73.6%), with a lower prevalence of amphetamine-type stimulants (12.5%), ketamine-type drugs (9.0%), and opioids (2.8%). The polydrug use patterns identified concurrent etomidate–amphetamine consumption (n = 5) and complex analog combinations (etomidate–isopropoxate–metomidate, n = 13), suggesting evolving abuse trends. Despite limitations in the temporal resolution and representativeness of the cohort, this study demonstrated the viability of TD-ESI-MS/MS for bridging forensic and public health priorities. Future work should focus on optimizing the durability of the ion source for TD-ESI and validating this method across diverse populations to enhance its generalizability. Full article

(This article belongs to the Special Issue Current Issues and Research Perspectives in Forensic Toxicology)

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Review

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14 pages, 406 KB

Open AccessReview

Acute Intoxication After Baclofen Administration: A Review of the Literature and Methodological Proposals

by Giuseppe Davide Albano, Mauro Midiri, Péter Attila Gergely, Tamás Gergő Harsányi, Kálmán Racz, Alessandra Matilde Nivoli, Roberto Buscemi, Stefania Zerbo, Antonina Argo and Claudia Trignano

Toxics 2025, 13(11), 999; https://doi.org/10.3390/toxics13110999 - 20 Nov 2025

Viewed by 2134

Abstract

Baclofen intoxication, once rare, is now increasingly observed in clinical and forensic settings due to its expanding medical and off-label use. However, baclofen is not routinely included in standard postmortem toxicological panels and is usually tested only when explicitly requested. This selective approach, together with the lack of validated cut-offs and standardized interpretative protocols, complicates both clinical management and postmortem evaluation. A systematic review of the literature published between July 2005 and July 2025 was conducted according to PRISMA guidelines, including fatal and non-fatal baclofen intoxications with quantitative toxicological data. Analytical methods, biological matrices, concentration ranges, and clinical outcomes were compared to identify recurring patterns and interpretative gaps. A fatal intrathecal overdose case was also analyzed as a paradigmatic example of diagnostic and methodological challenges. In thirteen studies meeting inclusion criteria and comprising over 300 cases, reported blood concentrations ranged from 0.04 to 110 mg/L, with overlapping values between survivors and fatalities. The analysis revealed marked heterogeneity in matrices and methods, and a poor correlation between concentration and clinical severity, limiting the reliability of toxicological interpretation in both clinical and postmortem settings. Baclofen intoxication illustrates the challenges of interpreting toxicological data without harmonized analytical criteria and highlights the need for standardized procedures and shared reference databases to improve diagnostic and medico-legal accuracy. Full article

(This article belongs to the Special Issue Current Issues and Research Perspectives in Forensic Toxicology)

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56 pages, 661 KB

Open AccessReview

Analytical Methods for the Determination of Diamorphine (Heroin) in Biological Matrices: A Review

by Ahmed Ibrahim Al-Asmari

Toxics 2025, 13(10), 867; https://doi.org/10.3390/toxics13100867 - 13 Oct 2025

Viewed by 2734

Abstract

Diamorphine (DIM, heroin) is a semi-synthetic opioid that undergoes rapid conversion to 6-monoacetylmorphine and morphine, producing short-lived biomarkers that are difficult to capture during the process. This review critically explores the evolution of analytical techniques for quantitative DIM analysis in biological matrices from 1980 to 2025. It synthesizes findings across blood, plasma, urine, hair, sweat, and postmortem samples, emphasizing matrix-specific challenges and forensic applicability. Unlike previous opioid reviews that primarily focused on metabolites, this work highlights analytical methods capable of successfully detecting diamorphine itself alongside its key metabolites. This review examines 32 studies spanning three decades and compares three core analytical methods: gas chromatography–mass spectrometry (GC–MS), high-performance liquid chromatography (HPLC) with optical detection and liquid chromatography–mass spectrometry (LC–MS). Key performance metrics include sensitivity, sample preparation workflow, hydrolysis control, metabolite coverage, matrix compatibility, automation potential and throughput. GC–MS remains the workhorse for hair and sweat ultra-trace screening after derivatization. HPLC with UV, fluorescence or diode-array detection enables robust quantification of morphine and its glucuronides in pharmacokinetic and clinical settings. LC–MS facilitates the multiplexed analysis of DIM, its ester metabolites and its conjugates in a single, rapid run under gentle conditions to prevent ex vivo degradation. Recent advances such as high-resolution mass spectrometry and microsampling techniques offer new opportunities for sensitive and matrix-adapted analysis. By integrating validation parameters, forensic applicability, and evolving instrumentation, this review provides a practical roadmap for toxicologists and analysts navigating complex biological evidence. Full article

(This article belongs to the Special Issue Current Issues and Research Perspectives in Forensic Toxicology)

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Other

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10 pages, 600 KB

Open AccessCase Report

Domestic Abuse of Codeine: A Case Study of Non-Medical Use Leading to Fatal Outcome

by Karolina Mrochem, Ewelina Pieprzyca, Gabriela Skalniak, Jakub Obrzut, Julia Cieśla, Elżbieta Chełmecka, Marcin Tomsia and Rafał Skowronek

Toxics 2026, 14(1), 71; https://doi.org/10.3390/toxics14010071 - 13 Jan 2026

Viewed by 1300

Abstract

Codeine, an opioid analgesic present in many over-the-counter (OTC) formulations, is frequently misused through non-medical extraction techniques such as cold water extraction (CWE). These practices carry substantial risks, including incomplete removal of hepatotoxic co-formulants, contamination, and highly unpredictable dosing. We report a fatal case of a 29-year-old man who ingested codeine extracted from Antidol^® tablets in combination with energy drinks and psychotropic medications. Post-mortem LC–MS/MS analysis revealed the presence of codeine (0.66 µg/mL), morphine (0.02 µg/mL), hydroxyzine (2.52 µg/mL), alprazolam (0.15 µg/mL), paracetamol (30.64 µg/mL), and additional substances in blood samples. Concentrations of codeine and hydroxyzine exceeded therapeutic ranges and were consistent with values reported in fatal intoxications, confirming a poly-drug poisoning. This case highlights the danger associated with non-medical codeine use, particularly when combined with central nervous system (CNS) depressants, and underscores the need for stricter regulation of OTC codeine-containing products as well as improved public awareness of the risks associated with domestic extraction methods. Full article

(This article belongs to the Special Issue Current Issues and Research Perspectives in Forensic Toxicology)

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