The opioid epidemic resulted in an increase in identifications of fentanyl, fentanyl analogs, and heroin, among other opioids, in the toxicology and seized drug analysis fields over the past several years. The Dallas County Southwestern Institute of Forensic Sciences, comprised of the Toxicology Laboratory and Drug Analysis Laboratory, observed a rise in fentanyl-positive analyses in both laboratories. Fentanyl positivity increased from 1.1% to 3.4% in the Toxicology Laboratory over the five years of this study, whereas 6-monoacetylmorphine (6-MAM) positivity remained relatively stable at approximately 2%. Similarly, in the Drug Analysis Laboratory, the fentanyl positivity rate changed from 0.03% to 0.60%, whereas heroin identification remained stable at approximately 8-9%. Based on data obtained from toxicology submissions, a typical fentanyl or heroin user was a white male in their late 30s. The average concentration of fentanyl in postmortem cases, antemortem cases, and 6-MAM in postmortem specimens was 9.7 ng/ml, 5.5 ng/ml, and 68.4 ng/ml, respectively. Poly-drug use was evident, with benzodiazepines being the most commonly co-administered drug with fentanyl (49.4%). Multiple drugs were identified via analysis of clandestine tablets submitted to the Drug Analysis Laboratory, including fentanyl and/or heroin in combination with compounds such as cocaine, etizolam, and acetaminophen. The most frequently identified clandestine tablet was "M367," typically manufactured to contain acetaminophen and hydrocodone, but was found to contain fentanyl or heroin. The results from this study aid in the understanding of the current opioid trends in Dallas County and provides an opportunity for comparison to other populations and geographical regions.

Presented are phencyclidine (PCP)-positive cases received by the Toxicology Laboratory at the Southwestern Institute of Forensic Sciences from local law enforcement agencies and the Office of the Medical Examiner (OME) between 1 January 2015 and 31 December 2020. Of the 43,940 requests for testing received during that time, 898 (2.04%) were positive for PCP. These cases were evaluated for PCP concentration, additional/concurrently reported drug concentrations and demographics. For ME cases, the cause and manner of death were also evaluated. Although the number of requests received by the Toxicology Laboratory increased each year, the percentage positive for PCP remained consistent. Subjects ranged from 18 to 71 years old (median 48 years) and were predominantly black (94.19%) and male (78.49%). PCP concentrations for all case types ranged from 0.02 to 2.33 mg/L (median 0.05 mg/L); driving while intoxicated (DWI) cases ranged from 0.02 to 0.14 mg/L (median 0.04 mg/L) and ME cases ranged from 0.02 to 2.33 mg/L (median 0.13 mg/L). In addition to PCP, one or more drug(s) or metabolite(s) was identified concurrently in 69.49% of cases. Cannabinoids were the most frequently detected (39.8%), followed by cocaine and its metabolites (22.0%) and ethanol (18.5%). Results were similar when comparing the additional drugs reported in ME and DWI cases. PCP concentrations in ME samples were generally higher, especially for stimulant drugs. Of the 264 ME cases positive for PCP, the manner of death was determined to be an accident for the majority of cases (62.54%), and the most common cause of death was drug toxicity (35.61%). The results from this study facilitate comparison of laboratory- or region-specific data sets, help determine whether laboratory scopes meet testing needs, contribute to reference ranges and provide the foundation for well-informed policy decisions.