Matteo A Sacco, Saverio Gualtieri, Chara Spiliopoulou, Alessandro P Tarallo, Maria C Verrina, Isabella Aquila
Overdose involves the administration of one or more narcotic substances in quantities exceeding the body's tolerance threshold, leading to toxic effects ranging from mild to fatal. The clinical manifestations of an overdose vary depending on the toxic substance's specific molecular action, such as stimulation or suppression of the nervous system. Common toxic agents include synthetic opioids like fentanyl, cocaine, barbiturates, benzodiazepines, and cannabinoids. This study emphasizes the critical role of forensic toxicology in identifying overdose deaths, focusing on the molecular mechanisms of toxicity, post-mortem redistribution, and the interpretation of toxicological findings. Advanced methodologies such as gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) are discussed as pivotal tools for identifying toxic substances and their metabolites. Biological matrices such as blood, urine, vitreous humor, and organ tissues are evaluated for their utility in toxicological investigations. Accurate interpretation of results informs not only the cause of death but also patterns of substance abuse, contributing to the development of preventive strategies. This study highlights the growing complexity of psychoactive substances, emphasizing the necessity for precise and innovative toxicological techniques in forensic practice.
