The Drug Expert: A Practical Guide to the Impact of Drug Use in Legal Proceedings

Cover
The Drug Expert:
A Practical Guide to the Impact
of Drug Use in Legal Proceedings
Copyright
About the Author
Preface
Acknowledgments
1
 What a Long Strange Trip It’s Been: Our drugged society
	Drug Use by Americans—Drugs and Mental Illness—Drugs and Crimes Drug Effects on Brain and Behavior—Drug Use and the Legal  ...
	Drug Use by Americans
		Prescription drug use
		Nonprescription drug use
		Alcohol use
		Illegal drug use
	Drugs and Mental Illness
		Self-medication for anxiety
		Self-medication for mood disorders
		Self-medication for schizophrenia
	Drugs and Crimes
	Drug Effects on Brain and Behavior
		A primer on neuropharmacology
		Rewarding drugs
		Neurotoxic drugs
		Classes of drugs affecting brain and behavior
	Drug Use and the Legal System
		Types of legal cases
		The drug expert
2
 A Parent’s Worst Nightmare: Drug-induced psychosis and deadly police force
	Over-the-Counter Drug Abuse—Benadryl® and the BrainTesting for Drug Use in the Recently Dead—Finding the Drug ExpertThe D ...
	Over-the-counter drug abuse
		Dextromethorphan abuse
	Benadryl® and the brain
		Diphenhydramine abuse
	Testing for drug use in the recently dead
	Finding a drug expert
	The Drug Expert’s Initial contact with an Attorney
3
 Show Me the Money: Epilepsy drugs and the four million dollar embezzlement
	Overview of the Legal Infrastructure—Movement of Drugs in the Body Epilepsy, Antiepileptic Drugs, and the Law—Adverse Brai ...
	Overview of the Legal Infrastructure
	Movement of Drugs in the Body
	Epilepsy, Antiepileptic Drugs, and the Law
		Epilepsy, automatism, and the law
	Adverse Brain Effects of Phenobarbital
	Drug use and Criminal Responsibility
		Drug use as diminished capacity
	The Drug Expert Letter of Engagement
4
 The Power of the Poppy: Opioid overdose in the treatment of pain
	Treatment of Cancer Pain with OpioidsOfficial Prescribing Information for Drugs Medical Malpractice Due to the Prescribin ...
	Treatment of Cancer Pain with Opioids
		Fentanyl transmucosal lozenges (Actiq®) and fentanyl transdermal patches (Duragesic®)
	Official Prescribing Information for Drugs
	Medical Malpractice Due to the Prescribing of Opioids
	Federal Rules of Evidence and the Expert
	The Drug Expert Litigation Report
5
 Wrong Place at the Wrong Time: Meth manufacture and urine drug tests
	The Drug Treatment Court Alternative—A Profile of MethamphetamineEnvironmental Exposure When Making MethThe Detection of ...
	The Drug Treatment Court Alternative
	A Profile of Methamphetamine
	Environmental Exposure When Making Meth
	The Detection of Methamphetamine in Urine
	Rules of Discovery for the Drug Expert
	Deposition of the Drug Expert
		Standard of care limits for a drug expert
6
 Hairs of the Innocent: Detection of marijuana in a child custody case
	A Profile of Marijuana—Drug Use in PregnancyDrug Use by Parents and Child Maltreatment—Testing for Drugs in Hair SamplesD ...
	A Profile of Marijuana 1
		Mechanism of action of marijuana
		Pharmacokinetics of marijuana
	Drug Use in Pregnancy
	Drug Use by Parents and Child Maltreatment
		Child custody and marijuana use
	Testing for Drugs in Hair Samples
		Testing hair samples for marijuana use
	Drug Expert Testimony in Court
7
 Firewater: Alcohol abuse and tribal homicide
	The Drug Alcohol—Alcohol Effects on the Brain and AggressionResearch Methods of the Drug Expert—Alcohol Abuse in Native Am ...
	The Drug Alcohol
	Alcohol Effects on the Brain and Aggression
		Behavioral disinhibition produced by alcohol
		Alcohol use and cognitive dysfunction
		Alcohol use associated with impulsivity
		Alcohol use associated with aggression and violence
	Research methods of the Drug Expert
	Alcohol Abuse in Native Americans
	Junk Science and the Drug Expert
8
 Death at the Crossing: Trace cocaine and the denial of benefits
	A Profile of Cocaine—Drug Testing in the WorkplacePostmortem Redistribution of Drugs—Criteria of a Substance Use Disorder ...
	A Profile of Cocaine
		Cocaine metabolism and blood concentrations
	Drug Testing in the Workplace
		Preliminary presumptive and confirmatory drug tests
		Mandated second or confirmatory drug tests
	Postmortem Redistribution of Drugs
		Drug distribution in the dead
		Postmortem redistribution
		Interpretation of cocaine blood levels
	Criteria of a Substance Use Disorder
	The Drug Expert and the Toxicology Report
9
 Big Little Secrets: Prescription errors, generic drugs, and drugs affecting blood alcohol
	Medication Errors and Patient Injury—Generic and Brand Name DrugsDrug Interference in Alcohol Testing—The Drug Expert and ...
	Medication Errors and Patient Injury
		Adverse effects of oral diabetes drugs give to a nondiabetic patient
	Generic and Brand Name Drugs
		Generic drugs and generic substitution
		Are generic and branded drugs the same?
		Background on drug hypersensitivity (“drug allergy”)
	Drug Interference in Alcohol Testing
		Metabolism of ethanol
		Drugs that interfere with alcohol metabolism
		Etomidate
		Cefazolin
		Acetaminophen
	The Drug Expert and Medical Records
10
Through the Looking-Glass: A bank-robbery witness and alleged victim on drugs
	Drug Effects on Memory and Perception—Cognitive Effects of Common DrugsThe Public Defender’s Office and the Drug ExpertTh ...
	Drug Effects on Memory and Perception
		Drug effects on the brainstate
	Cognitive Effects of Common Drugs
		Duloxetine
		Tramadol
		Oxycodone
		Clonazepam
		Pregabalin
		Alprazolam
		Marijuana
		Alcohol (ethanol)
		Interactions among drugs used by the witness and alleged victim
	The Public Defender’s Office and the Drug Expert
		The right to hire and the reimbursement of drug experts
	The Drug Expert and Pharmacy Records
11
 I Want a New Drug: Fake marijuana, designer stimulants, and hallucinogens
	Designer Drugs in the Age of Synthetics—The Controlled Substances ActScheduling of Controlled Substances—Federal Drug Sent ...
	Designer Drugs in the Age of Synthetics
		Synthetic marijuana (THC)-like drugs
		Synthetic CNS stimulant/hallucinogenic drugs
	The Controlled Substances Act
		Controlled Substances Analogue Enforcement Act
	Scheduling of Controlled Substances
	Federal Drug Sentencing Guidelines
		Drug offender sentencing guidelines
	The Business of Being a Drug Expert
12
 Where There’s a Will, There’s a Way: Cancer chemotherapy and probate
	Anticancer Drugs and Chemobrain —Chronic Alcoholism and NeurotoxicityMaking a Will and Drug Use—Drug-Induced Diminished C ...
	Anticancer Drugs and Chemobrain
		Neurotoxicity and cognitive dysfunction due to fluorouracil treatment (5-FU)
		Neurotoxicity and cognitive dysfunction due to oxaliplatin
		Neurotoxicity and cognitive dysfunction due to bevacizumab
	Chronic Alcoholism and Neurotoxicity
	Making a Will and Drug Use
	Drug-Induced Diminished Capacity
	Estimation of BAC From Alcohol Consumed
13
 Speed Kills: Two cases of methamphetamine abuse and homicide
	Drug Addiction in a NutshellMethamphetamine-Induced Violence, Aggression, and PsychosisPhases of Criminal Trials—Admissib ...
	Drug Addiction in a Nutshell
		Mechanism of drug addiction
	Methamphetamine and Violence, Aggression, and Psychosis
		Methamphetamine use increases impulsive behavior, hostility, and aggression
		Methamphetamine use is associated with violence in both perpetrators and the victims
		Methamphetamine use causes changes in brain structure and function
		Amphetamine and methamphetamine psychosis
	Phases of Criminal Trials
		Stages of a criminal case 30
	Admissibility of Scientific Expert Testimony
	Daubert Challenge to Drug Expert Testimony
14
The Truth Shall Not Set You Free: A drug-induced confession
	A Short History of Drug-Induced ConfessionsDrug-Induced Confessions and the Drug ExpertDisruption of Thinking and Memory ...
	A Short History of Drug-Induced Confessions
	Drug-Induced Confessions and the Drug Expert
	Disruption of Thinking and Memory Due to Drugs
		The adverse effects of opioid analgesics on the brain
		The adverse effects of atypical antipsychotics on the brain
		The adverse effects of benzodiazepine sedative-hypnotics on the brain
		The adverse effects of antihistamine sedative-hypnotics on the brain
		Synergy of CNS depressant drugs
	Involuntary Drug Intoxication
	The Pharmacist Versus the Pharmacologist Drug Expert
15
 Snake Eyes: Gambling with the adverse effects of Ambien®
	Sleep Drugs—Drug Laws and Regulations—Approval of New Drugs by the FDAThe Dangers of Ambien® Use—Examining Pharmacokinetic ...
	Sleep Drugs
		Drug therapy for inducing and maintaining sleep
	Drug Laws and Regulations
		FDA’s drug regulation laws
	Approval of New Drugs by the FDA
	The Dangers of Ambien® Use
		Homicide and suicide associated with Ambien® use
	Examining Pharmacokinetics for Drug Dose and Time
	The Drug Expert and Big Pharma Litigation
		Pharmaceutical tort cases against Ambien®
16
 Reefer Madness: Driving under the influence of marijuana
	The State Legalization of Medical and Recreational MarijuanaDrugged Driving Laws—Marijuana and Driving ImpairmentUsing Pr ...
	The State Legalization of Medical and Recreational Marijuana
		State legalization of medical marijuana
		State legalization of recreational marijuana
	Drugged Driving Laws
		Per se drugged driving laws
	Marijuana and Driving Impairment
		Time of last marijuana use
	Using Private Drug Testing Laboratories
	Training Programs for Drug Experts
17
 A Visit to the Dram Shop: Tequila shots and a traffic fatality
	Dram Shop Law for the Drug Expert—Driving Under the Influence of AlcoholThe Use and Misuse of the BreathalyzerRetrograde ...
	Dram Shop Law for the Drug Expert
	Driving Under the Influence of Alcohol
	The Use and Misuse of the Breathalyzer 28
	Retrograde Calculation of Blood Alcohol Concentrations
	Drug Recognition Experts
	Marketing of the Drug Expert
18
 The Devil Made Me Do It: Rape after prison release of an untreated schizophrenic
	Antipsychotic Treatment of Schizophrenia—Treatment of Mental Illness in Prison Postrelease Treatment of Mentally Ill Offen ...
	Antipsychotic Treatment of Schizophrenia
		Antipsychotic drugs and their mechanism of action
	Treatment of Mental Illness in Prison
		Forced medication of captured schizophrenics with antipsychotics
	Postrelease Treatment of Mentally Ill Offenders
	Psychedelic Drugs Used in Psychiatry
		Therapeutic use of hallucinogens and ketamine
		Microdosing
	The Drug Expert and Nonuse of Drugs
19
 Dead Men Tell No Tales: Drug levels in a drowned, a decayed, and a dumpster corpse
	Insurance Claims and Drug UseDrug Detection in Fluid From the Eyeballs and Other PlacesPostmortem Detection of Alcohol an ...
	Insurance Claims and Drug Use
	Drug Detection in Fluid From the Eyeballs and Other Places
		Vitreous humor fluid samples for postmortem detection of drugs
		Liver samples for postmortem detection of drugs
		Other tissue sources for postmortem drug detection
	Postmortem Detection of Alcohol and Methamphetamine
		Vitreous fluid sample for alcohol determination
		Postmortem redistribution of alcohol
		Postmortem production of ethanol
		Postmortem redistribution of methamphetamine
	Fetal Remains and Maternal Drug Use
		Methamphetamine effects on the fetus
		Methamphetamine in fetal liver samples
	The Toxicologist and the Pharmacologist Drug Expert
20
 Death Be Not Proud: The pharmacology of lethal drug executions
	Let Me Be Perfectly Clear—Capital Punishment by Lethal Drug InjectionLethal Drugs From Compounding PharmaciesThe Supreme ...
	Let Me Be Perfectly Clear
	Capital Punishment by Lethal Drug Injection
		Oklahoma introduces a new method of execution using a three-drug lethal injection protocol
			Thiopental
			Pancuronium
			Potassium chloride
		Oklahoma replaces thiopental with pentobarbital as first drug in triple-drug protocol
			Pentobarbital
		Florida switches from pentobarbital to midazolam as first drug in triple-drug protocol
		Ohio uses midazolam and hydromorphone in new two-drug protocol
			Midazolam
			Hydromorphone
		Florida switches from midazolam to etomidate as first drug in a three-drug protocol
			Etomidate
		Nebraska goes with diazepam and fentanyl in new four-drug protocol
			Diazepam
			Fentanyl
			Cisatracurium
			Potassium chloride
	Lethal Drugs From Compounding Pharmacies
	The Supreme Court of the United States and Lethal Injection Drugs
	Alternative Methods of Execution
		Missouri’s proposed use of propofol in a new triple-drug protocol
			Propofol
		Nevada goes with a new three-drug protocol
			Midazolam
			Fentanyl
			Cisatracurium
		California’s proposes a single-drug protocol using a barbiturate
		Oklahoma legislates a nitrogen gas alternative
			Nitrogen hypoxia
			Nitrogen and helium gas use in suicide
	Epilogue and Conclusions
Appendix A: List of medical schools by city and state, including phone number
Appendix B: Sample letter of engagement for the drug expert
Appendix C: Sample invoice for the drug expert
Appendix D: Excerpt of litigation report
Appendix E: Excerpt of drug expert deposition
Appendix F: Excerpt of a court transcript cross-examination
Appendix G: Sample toxicology reports
Appendix H: Sample medical records
Appendix I: Sample pharmacy records
Appendix J: Alcohol charts for males and females
Appendix K: Excerpt of Daubert motion against the drug expert
Appendix L: Drug tests available at commercial laboratories
Appendix M: Retrograde calculation of blood alcohol concentration (BAC)
Index
	A
	B
	C
	D
	E
	F
	G
	H
	I
	J
	K
	L
	M
	N
	O
	P
	R
	S
	T
	U
	V
	W
	X
	Z
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