All ETDs from UAB

Advisory Committee Chair

Elizabeth Gardner

Document Type

Thesis

Date of Award

2024

Degree Name by School

Master of Science in Forensic Science (MSFS) College of Arts and Sciences

Abstract

The opioid epidemic started in the early 1990s with the rise of prescription overdoses. In more recent years, heroin and fentanyl use has rapidly increased. Fentanyl, specifically, is 50 to 100 times more potent than morphine. To keep up with the ever-evolving epidemic, the Randox MultiSTAT was validated for use in the medical examiner autopsy suite for the potential to aid medical examiners in triaging the need for a full autopsy versus an external examination with toxicology testing. The Randox MultiSTAT is a triage tool and investigatory screen designed to provide presumptive test results across multiple matrices. It can detect up to 20 drugs and drug classes from a single sample in under 20 minutes. False positive and false negative rates, specificity, sensitivity, accuracy, positive predictive values, and negative predictive values were calculated for all drugs except for ETG. Overall, the MultiSTAT had a false positive rate of 1.0% and a false negative rate of 1.4%. All other parameters were >90% as well. External and full examinations were performed on 61% and 39% of cases respectively. Using this data, the MultiSTAT shows great promise in aiding the medical examiners in the autopsy suite. In addition, the number of fentanyl overdoses in Alabama in 2022 was determined, excluding Jefferson County. In 2022, there were 1,832 overdose cases submitted to the Alabama Department of Forensic Sciences. Of these, 1,304 (71%) were opioid overdoses. Fentanyl was detected in 709 cases (39%)

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