Sudden death associated with intravenous injection of toad extract.
Forensic science international July 1, 2009 DOI: 10.1016/j.forsciint.2009.02.006 via PubMed
Summary
AI-generated from the abstractA 24-year-old man died after injecting what he believed was MDMA (ecstasy), but toxicology revealed no MDMA in his blood or the injected material. Instead, low levels of bufotenine—a toxin from toad secretions—and three bufadienolides (resibufogenin, cinobufagin, bufalin) were found in the injected substance. The presence of paracetamol, promethazine, and diclofenac matched ingredients in Chan Su, a traditional Chinese toad-venom product often adulterated with pharmaceuticals. This case highlights the risks of unknown street-drug compositions and the challenges of detecting low-level organic toxins in postmortem samples, requiring targeted screening guided by scene information.
Study at a glance
| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A 24-year-old male |
| Topics | 5-MeO-DMT |
| Keywords | Drug adulteration Drug contamination Illicit drug mixtures Unknown drug compositions Street drug dangers |
| Citations | 56 |
| Key finding | The injected substance contained bufotenine and toad-venom bufadienolides rather than MDMA, consistent with the traditional Chinese product Chan Su, leading to a fatal outcome. |
Abstract
A 24-year-old male died suddenly following the intravenous injection of what was believed to be the ring-derivate amphetamine 'ecstasy' (MDMA). Toxicological analyses of the victim's blood and the injected material, however, failed to reveal MDMA, but showed instead low levels of bufotenine, a tryptamine derivative alkaloid found in the secretions of various toads. In addition, resibufogenin, cinobufagin and bufalin, bufadienolides that are also found in toad venom, were identified in the injected material. While these substances also occur in certain South American plants, the finding of paracetamol, promethazine and diclofenac would be in keeping with ingredients found in the traditional Chinese herbal product Chan Su that derives from the skin glands and secretions of toads and that is often adulterated with standard pharmaceutical drugs. This case demonstrates the problems that users and sellers may encounter from the unknown composition of street drugs and herbal medicines, and the danger that may be incurred from the injection of such materials. It also shows the difficulties that may be associated with attempting to identify low levels of organic toxins in postmortem specimens necessitating a targeted screening approach guided by information obtained at the death scene.