The Analytical Zen Podcast

From Energy Drinks to Drugs: Uncovering Stimulants

Geraldine M. Dowling Episode 10

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In this episode, forensic toxicologist Dr. Karolina Nowak takes  us into the world of forensic toxicology, from the energy drinks we consume daily to the dangerous synthetic drugs on the streets.  Dr. Nowak discusses the growing issues surrounding stimulant use, including the rise of synthetic drugs and the overlooked dangers of legal substances like caffeine. With a unique perspective from her experience in Poland, she sheds light on how forensic toxicologists protect public health, track emerging threats and advance the science of substance analysis. Tune in if you're curious about the intersection of science, crime and public safety.

Introduction to Dr. Karolina Nowak

Speaker 1

Welcome to the Analytical Zen Podcast, where we delve into the minds of leading scientists and professionals exploring forensics, toxicology, medicine and health in terms of mind, body and spirit. I'm your host, geraldine M Dowling. What should you expect in the Analytical Zen podcast? Well, we dive into cutting edge research and topics that inspire curiosity, the latest in forensic and clinical toxicology pursuits, and engage in conversations and perspectives from disciplines outside of these fields. We're thrilled to have Dr Karolina Nowak as our guest on the Analytical Zen podcast.

Speaker 1

Dr Nowak studied Medical Laboratory Science at Wroclaw Medical University in Poland. In her fifth final year, she was awarded a diamond grant by the Polish Ministry of Science and Higher Education, which provided a direct pathway to her PhD studies at the Department of Forensic Medicine at Wroclaw Medical University. She obtained her PhD in Medical Sciences in 2020. She also completed postgraduate studies in chromatography and related techniques in modern analysis at the University of Łódź.

Speaker 1

After completing her studies, dr Nowak worked in both medical diagnostic laboratories and a forensic toxicology laboratory, gaining extensive experience in both fields. In 2023, she passed the national examination and obtained the title of specialist in forensic laboratory toxicology. For several years, she has been affiliated with the Institute of Toxicology Research, where she currently works as a forensic toxicologist, holding the position of Toxicology Research, where she currently works as a forensic toxicologist, holding the position of Senior Specialist. Since 2022, she has also been employed at the Department of Pharmacology University of Opolę, initially as a Senior Lecturer and since 2023, as an Adjunct. Dr Nowak is a member of the Polish Society of Forensic Medicine and Criminology, as well as the International Association of Forensic Toxicologists, certiaft. Welcome, dr Nowak.

Speaker 2

Hello Darlene. Thank you for the invitation. It's a pleasure to be here and, of course, warm welcome to all the listeners of the podcast.

Speaker 1

Carolina, thank you so much. It's an absolute pleasure to have you. Carolina, can you tell us how did your journey into forensic toxicology begin?

Speaker 2

Yes, so, as you said, I studied medical laboratory science and actually in my first year I joined the forensic analytics and criminal chemistry as student research cycle and the supervisor of our research group. Actually, one of my current bosses had a real talent for inspiring students with his passion for forensic toxicology. So that was the beginning of my life with forensic toxicology. And so I'm not a chemist, biochemist, pharmacist or so on, and actually it's quite unusual for a medical laboratory scientist like me to be working in TOCS lab. But I do appreciate that fact because my medical background helps me a lot, especially when interpreting toxicological results in conjunction with medical reports or clinical data, with medical records or clinical data, and also, as you mentioned, a few years ago, I joined the TIAFT community, so thanks to annual meetings, I've had the chance to meet many inspiring people from the world of forensic psychology, so I also am really happy to be a part of this community.

Speaker 1

I absolutely love being part of the TIAT community. What are your main areas of interest?

Speaker 2

So I pay special attention to research of xenobiotic stability, a particularly long-term stability. Unfortunately, in our routine work we have to analyze samples weeks or even months after collection, so that's why information on the stability of substances in biological materials is extremely important to us, and also in forensic reports. Sometimes we need to assess whether a given substance remains stable over time or how the passage of time has affected the determined concentration of xenobiotics. Additionally, at the Institute of Toxicology Research, we also analyze various types of non-routine matrices, such as exhumed remains, placenta, paraffin-amended tissue blobs, teeth or insect larvae, and together with my team, we're working hard on developing a method for determination of xenobiotics in such various types of matrices.

Speaker 1

Karolina. What types of scientific research are particularly important to you?

Speaker 2

At the Institute of Toxicology and Research, I find my role as a forensic toxicologist and as a senior specialist I have the opportunity to analyze a wide range of samples and in addition to previously mentioned non-routine matrices, we conduct psychological analysis on samples collected from both living individuals and also a diseased person, and in autopsy cases in Poland, not only blood or urine is taken but also other fluids such as vitreous, humor or bile.

Speaker 2

Of course we also analyzed tissue samples like liver, kidney, stomach content, brain, sometimes intestine content. We also analyzed various types of hair, not only head hair, but also armpit hair or pelvic and chest hair. And apart from biological materials, we also analyze evidences like from basic ones, like tablets, powders, capsules, crystals, plant remains, for example, stained clothing, and also, as a team, we prepare forensic psychology reports. In the institute we pay particular attention to organic substances and when it comes to drugs, medication or new psychoactive substances, we've performed both targeted and non-targeted analysis. So we think that this comprehensive approach allows us to take on even the most challenging cases, and that's why we are not afraid of them cases and that's why we are not afraid of them, and actually I'm very glad to be a part of a very strong scientific team, both in terms of knowledge and years of experience.

Speaker 1

Karolina, do you encounter stimulants much in your professional work?

Speaker 2

To be honest, yeah, I would say that stimulants are commonly detected in samples both from living individuals like drivers, but also in post-mortem samples. I would say that, on one hand, classic substances like amphetamine, methamphetamine, mdma and cocaine remain popular in Poland, but on the other hand, synthetic carcinogens dominate the scene, particularly for chloromethatinone, methadrone and alpha-PVP and alpha-PVP, and this may be due partly, of course, to the high number of illegal laboratories in Poland producing this type of carcinoma. More unusual synthetic carcinomas or stimulants are very rarely encountered and, of course, when discussing stimulants, we can forget one of the most widely used. I mean caffeine. In our routine casework we also monitor its concentration and actually a few years ago this allowed us to confirm a fatal suicide case involving caffeine poisoning, and also that's why I encourage others to include caffeine in the routine for psychological analysis.

Speaker 1

And, in terms of other stimulants, what is the legal status of, and the majority of stimulants that you encounter in Poland?

Legal Status of Stimulants in Poland

Speaker 2

Yeah, okay. So the main act since 2005 is the act on counteracting drug addiction, which introduced a classification of substances into psychotropic substances, narcotic and so-called substitute substances, substances, narcotic and so-called substitute substances. In 2018, the first regulation by the Minister of Health regarding the list of psychotropic substances, narcotic and new psychoactive substances came into effect. So, for example, in addition to some change in classification of substances into specific groups of psychotropic substances, as in the narcotics, the regulation for the first time defined what new psychoactive substance is, and, at that time, 31 such substances were recognized as new psychoactive substances and, of course, many of which were synthetic cation. Furthermore, for the first time in history, a generic word was introduced for several groups of substances, meaning that any substance structurally fitting the established guideline was automatically classified as new psychoactive substance. And regarding, for example, stimulants, group one of NPS included analogs of 2-phenyl ethylamine and group two of NPS included analogs of catinone.

Speaker 2

And I would say that approximately once a year, a new regulation by the Minister of Health is enacted, for example, making change to the classification of substances, such a substance that was previously a new psychoactive substance and now being classified into one of the groups of psychotropic substances or narcotics. But also in 2014, another regulation by the Ministry of Health concerning substances acting similar to alcohol came in force. So, according to this regulation, substances acting similar to alcohol include opioids, amphetamine and its analogues, cocaine, tetrahydrocannabinols and benzos. And unfortunately, these are very broad statements and, moreover, more than 10 years have passed without any change to this regulation. And also this regulation does not address threshold concentration, for example, for determining drivings per mil for amphetamine and its analogues, 10 nanograms per mil for cocaine and 50 nanograms per mil for benzoyle agonin, which is, of course, one of cocaine metabolites, and to this day, we do not have legal and official threshold for those substances, and I hope one day it will change.

Speaker 1

Karolina. What about adolescents? Have any specific regulations been introduced to Poland?

Speaker 2

Apart from previously mentioned documents. For example, since January 1st 2024, people under 18 are prohibited from purchasing an energy drink containing caffeine at concentration exceeded 150 mg per liter, as well as taurine, but no further legal regulation has been introduced regarding this age group. In Poland after about 2010, the issue was a smart shops offering substituted substances such as synthetic carcinomes and cannabinoids, which were also available for online sale, and the scale of poisoning highlighted the problem in this age group and, of course, in toxicology.

Speaker 1

Did the caffeine in these types of drinks pose a danger to children and adolescents?

Monitoring Stimulant Poisonings

Speaker 2

Yes, according, for example, to the data from the National Institute of Public Health National Research Institute, about 2% of children in Poland aged 3 to 9, so such young people regularly consumed energy drink and regarding age group 10 to 17, it's about 30 percent. And in addition to caffeine and taurine, this type of drinks contain many substances particularly not intended and for people. Besides high sugar content, of course, they often include artificial colorings or flavor enhancers. So of course, there are some negative effects of consuming energy drink, such as a health problem, anxiety, sleep disorders, obesity, digestive issues and, of course, the potential for addiction.

Speaker 1

How are cases of stimulant poisoning monitored in Poland and in what ways? Karolina?

Speaker 2

district sanitary inspector and the suspicion of poisoning, the occurrence of poisoning and the death resulting from the use of substitute substance or a new psychoactive substance. Additionally, selected institutions need to submit quarterly reports on the detection of NPS, of NPS. However, as you see, this requirement is not limited to stimulants only. It's about all substitute substances and new psychoactive substance and it's not about, let's say, basic stimulants like amphetamine, mdma and cocaine.

Speaker 1

Are screening tests for stimulants conducted in clinical toxicology laboratories or general medical laboratories?

Speaker 2

Yes, so screening tests for stimulants in general medical laboratories are usually performed in urine and unfortunately cover a limited number of substances In terms of stimulants. They typically include amphetamine analogues, mdma, methadrone, cocaine, but actually in urine it's benzoyl agonin. So it's a very limited list of substances and unfortunately in Poland, aside from the information that test results, that its screening test should be confirmed with a reference method, there's no legal requirement for confirmatory testing, even in the case of positive results so.

Speaker 1

In your opinion, then, do these tests allow for understanding of the scale of stimulant abuse in poland?

Speaker 2

no, unfortunately no. Like in poland, there are also not many clinical psychology departments or acute poisoning treatment units, but even those often have limited resources for conducting confirmatory testing. Think is insufficient, and we don't fully know how many people are consuming illegal substances such as stimulants and actually what kind of substances they are.

Speaker 1

Are intentional, then, or suicidal stimulant poisonings, do you think, a common occurrence in Poland?

Speaker 2

Poland. So, from the statistic of Polish police, in 2024 alone there was almost 15 000 of suicide attempts in Poland and of this, 120 people attempted suicide, poisoning with chemicals or toxins, about 2,060 by taking sleeping pills or psychotropic drugs, about 2,300 by taking other medication and 29 cases for poisoning with narcotics. So, to sum up, it gave us about 4,500, so approximately one-third of all suicide attempts. And as for deaths, of these 15,000 suicide attempts, 4,845 resulted in deaths and, considering the causes mentioned earlier, deaths related to poisoning with substances were confirmed in 203 cases, but unfortunately there are no further statistics on stimulants only. But once again, I think that statistics are underestimated. For example, in the case of suicide deaths such as hanging, jumping from high, cutting blood vessels or trucking accidents, a full-text psychological analysis is often not performed at all or is limited to alcohol determination often. But for example, from cases described in literature, we know that sometimes suicide attempts are combined, for example, alcohol consumption and drug use, and in addition to hanging or cutting blood vessels. So that is it.

Speaker 1

Well, according to various reports, Poland is known in Europe for clandestine laboratories involved in the production of illegal substances, particularly stimulants. Could you provide some examples?

Speaker 2

Yes, unfortunately, poland often ranks at the top of Europe in this regard. Eoda, previously MCDDA, has frequently identified Poland as an infamous leader in synthetic catenone production. For example, from reports in 2022, four methamphetamine laboratories were dismantled in Poland 22 amphetamine laboratories, one MDMA laboratory and as many as 23 synthetic catenoneation laboratories out of 29 across whole EU in 2022. And, for example, in February this year, an illegal laboratory was shut down where over 50 kilogram of methadone and several ton of chemical reagents for production were sized, and it's estimated that in just four months of operation, they produce over 600 kilograms of methadone. Another example is dismantling of a chlorchloromethacatinone production laboratory in November last year, where approximately half ton of drugs were seized.

Impact of Ukraine Crisis and Future Outlook

Speaker 2

And I would like to say about an interesting case from last year involved the police discovering waste from the synthetic drug production in several locations. They identify a suspect, a man who may be involved in this case, and he was likely transporting these substances in his car, and it was actually a successful operation. And it was actually a successful operation. The man was stopped for check and the screening test gave positive results for amphetamine, methamphetamine and cannabinoids, and during the car search, police discovered amphetamine and marijuana. And the next step was searching the man's home, where they found over 100 grams of other drugs. But at that time police did not give up. They checked another building and they found out that there is a laboratory for methadone production. At that time they sized also methadone for prolomeprolomethatinone and 4-methylpropiofenol and, of course, precursors. And actually, according to the Polish Central Bureau of Investigation, in Poland 60 such laboratories were dismantled in 2024 alone in Poland.

Speaker 1

Reports also indicate that almost 70% of drug seizures by customs authorities occur in the ports of the European Union, and I've heard that recently a significant amount of cocaine was uncovered in Poland by the sea. Could you tell us a little bit more about this?

Speaker 2

Yeah, it was, I think in February this year so, over 100 kilograms of cocaine was discovered at the bottom of the Gawod Dynsk in the north of Poland. Originating this cocaine was from South America, and the drugs were hidden in plastic bags and weighted down with exercise equipment.

Speaker 1

And Poland shares a border with Ukraine and, due to the war, it has accepted a large number of immigrants. Do you think, karolina, that the situation in Ukraine has affected the stimulant situation in Poland? Has there been an increase in production or abuse?

Speaker 2

So I think probably that the situation in Ukraine could have played a role in the increase of stimulant-related criminal activities in Poland. I think the war and instability some opportunities for criminal groups to, for example, relocate their elite operation, including the production and distribution of synthetic catenones or other stimulants, to the polyfiltering. Exact data on how the war has influenced drug-related crimes in Poland may be, of course, insufficient, but of course I hope that Polish police will effectively target both domestic and foreign criminals involved in production and distribution of stimulants and, of course, illicit all illicit substances.

Speaker 1

Since January 1st 2025, poland has taken over the presidency of the Council of the European Union. Do you think this will provide an opportunity for a real fight against drug-related crime and stimulant abuse?

Speaker 2

fight against drug-related crime and stimulant abuse. Unfortunately, I think that the current political and economic situation would lead to European Union countries focusing on such issues, but I do believe that institutions focused on combating drug-related crime will use this time in 100 percent.

Speaker 1

Do you think that stimulants or opioids are a bigger problem in Poland and Europe?

Speaker 2

I think that this terrible opioid crisis affecting the USA has not spread to Europe on the same scale, and I hope that it never will. However, this does not mean that opioids are absent from the Polish or Europe market. I would say about one discovery of the largest methadone laboratory in Poland, and so I think it was in August last year. So the largest synthetic opioid laboratory was dismantled in Poland where methadone was produced, along with eight smaller laboratories in Poland and in Ukraine, where not only methadone was produced but also methadone and alpha-PVP 195 kg of methadone in crystalline form as well as 153 kg of alpha-PVP and a large quantity of precursors and reagents for production were sized and, as I mentioned earlier, this discovery of the largest methadone laboratory in Poland.

Speaker 2

I also see some opioids in postmortem samples, see some opioids in postmortem samples, taking into account opioids or opiates, my concerns are focused especially on oxycodone, which we relatively quite often detect. In addition, there are some cases with methadone, morphine and heroin use. Regarding fentanyl, unfortunately, although we do monitor many of these substances, such poisoning have not appeared recently. For example, sphagnum cases also seem to be very sporadic across the country. Cases also seems to be very sporadic across the country, but it's still important, however, to monitor as many substances as possible in our routine analysis, because only then we can talk about some trends and, of course, care of a given phenomenon. And to answer your question, I think opioids such as oxycodone and methadone are encountered in Poland, but stimulants ranging from the basic one like amphetamine, mdma, cocaine, to synthetic continence remain an ongoing issue in Poland.

Forensic Career and Aspirations

Speaker 1

Before we conclude, I'd like to ask you about your plans for the near and the distant future. Can you share anything with us?

Speaker 2

Not so much, but of course I would like to continue developing in forensic psychology and conduct new scientific research. I have several ideas for that. Currently I'm managing one project and of course, one of my dreams is to become a professor. So I will dedicate many things to achieve this goal in the future.

Speaker 1

Carolina, I actually have no doubt that that goal is going to be reached in the future. Are you planning to attend international conferences this year?

Speaker 2

So I would like to, but for now I plan to participate in the Forensic Psychologic Conference in Poland. I will definitely try to apply for travel grants to the TF meeting in Auckland. Actually, I would love to see New Zealand, not only because of the opportunity to exchange view and learn about the issue forensic psychology plays around the world, but also to get know the culture of New Zealand. I have never been to that part of the world, so it will be, for sure, an amazing adventure.

Speaker 1

Yeah absolutely, and I really do hope that we get to meet and have the opportunity to meet at another TIAT meeting and also to see New Zealand together. So, carolina, yeah, I hope to. Yeah, me too. Carolina, thank you so much for joining the analytical zen podcast and sharing your personal experience thank you, jordan.

Speaker 2

It was wonderful opportunity and all the best for you, and you're doing well with this podcast, so keep going.

Speaker 1

Thank you, carolina, I appreciate it. And to our listeners, thank you for tuning in to an episode of the Analytical Femme Podcast. Be sure to join us next time. Stay curious.