The Analytical Zen Podcast
Unveiling the Science Behind the Mystery: Exploring Forensics, Toxicology, Medicine and Health (Mind, Body and Spirit)
The Analytical Zen Podcast
From Lab Coats to Leading Labs: How a Work Placement Ignited Global Impact
What if a simple work placement could transform your entire career? Join us on the Analytical Zen Podcast as we sit down with Dr. Simon Elliott, a forensic toxicologist with over 30 years of experience. Simon shares memorable cases and pivotal experiences, including his work with the designer drug 4-Methylthioamphetamine (4-MTA) in his career, which sparked international collaborations and made significant contributions to global public health and safety. 4-MTA is a synthetic designer drug that is chemically related to amphetamines. It is part of the phenethylamine and amphetamine classes known for their stimulant and psychoactive effects.
We also explore the incredible advancements in toxicology analysis techniques over the past three decades, emphasizing the interdisciplinary nature of the field and the importance of passion and perseverance.
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Join the conversation at The Analytical Zen Podcast! Reach out to us via email at theanalyticalzenpodcast@gmail.com.
The opinions expressed by the guests are their own and do not necessarily reflect the views of The Analytical Zen Podcast.
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'll dive into cutting edge research and topics that inspire curiosity, the latest in forensic and clinical toxicology pursuits, and engaging conversations and perspectives from disciplines outside of these fields. Today, we have a truly exceptional guest with us.
Dr Geraldine Dowling SFHEA:With over 30 years of experience in clinical and forensic toxicology, Simon Elliott is a consultant forensic toxicologist and director of Elliott Forensic Consulting Limited and Toxicology UK Limited. He is also a visiting professor in forensic toxicology at King's College London, where he imparts his wealth of knowledge to the next generation of scientists. He is a chartered scientist, registered toxicologist, as well as being an active member of a number of professional bodies, including the Chartered Society of Forensic Sciences and the Royal Society of Chemistry, in addition to being a founding council member and past chair of the United Kingdom and Ireland Association of Forensic Toxicologists, and he is the current president-elect of the International Association of Forensic Toxicologists, or TIAFT. Simon's expertise extends to providing toxicology evidence in civil, criminal and coronial courts for more than 25 years. He has even lent his knowledge to esteemed organisations like the World Health Organisation and the United Nations. We're thrilled to have Dr Simon Elliott as our guest on the Analytical Zen podcast.
Simon:Welcome as our guest on the Analytical Zen podcast.
Dr Geraldine Dowling SFHEA:Simon, can your tell our listeners a bit about your journey in toxicology and what inspired you to pursue this field for 30 years?
Simon:Yes, a good question, and a good question to start with, the answer is probably a bit unusual. It was not my intention to be a toxicologist, it was an accident.
Simon:I did know that I wanted to get into forensic science, but in the late 80s there wasn't a lot of ways into it. I did apply to the Forensic Science Service and they basically said get a degree. I was looking at what degrees to do. But the TV nowadays people know that TV has a lot of different avenues. People can see about forensics on TV, but in those days there was no TV forensics. We'd had Quincy in the 80s and so forth. But there was a program called Indelible Evidence that was on BBC Two and that would be essentially true crime and it would go through some of the forensics that were involved in the day and I thought, oh, that's quite interesting, that's what I'd like to do.
Simon:So after the FSS said, you know, get a degree, it's like well, get a degree in what? And I had a science interest, so biology and chemistry were the primary sort of A-levels I did, along with maths. So realistically it was a case of looking at what can you do with biology and chemistry and you can join the two and do biochemistry. I thought biochemistry would be a good one to do, so I went to the University of Bath to do biochemistry. Now, the important thing was was that just before I went to the university, I'd taken a year out to do some work experience, and my work experience was in a hospital Birmingham City Hospital and I was working in pathology and my job was to go around the hospital looking at the control of substances hazardous to health, or COSH, and that involved me talking to lots of different people.
Simon:And one of the labs that I came across on the hospital site was the toxicology lab, and when I went in there to speak to the toxicologists and to learn a little bit more about what happened in the toxicology lab, they were the first to mention the word forensics to me, and I thought, oh, okay, so I can do forensics. Maybe if I work in a hospital, can I? So that was the aim was to go and get a degree in biochemistry, and when I was at that university you were able to do a placement, a sandwich course it's called doing industrial placement, an internship maybe, for want of a better word and I did that as part of my degree back at the hospital within the toxicology department. So I returned back to the place. So I didn't plan to be a toxicologist. I sort of fell into it and when I was in the lab all my experiments worked which they never did at university.
Dr Geraldine Dowling SFHEA:S imon, during my undergraduate years after I'd completed only second year, which, as you know, is mainly just theory modules in any undergraduate degree I initially aimed to try for a student project during the summer at the Marine Institute, and I was looking for one in the analytical science area. The Marine Institute is Ireland's national agency responsible for marine research, technology development and innovation. They didn't offer me an analytical project, but they did offer me a position looking at salmon tagging and it was a project for eight weeks in the summer between second and third year. It absolutely wasn't related to my degree, but I did accept it. While working there, though, I took the initiative to meet the head of the analytical lab, so I told them of my interest to study and work on analytical projects there. This paid off, as the following year, during my third year, I actually was allowed to focus on looking at contaminants in farmed salmon in one of my research projects, and then I was offered a project in the summer for eight weeks. So after working on that project, I then completed my degree and graduated and I was actually offered a permanent job in the Marine Institute looking at biotoxins in shellfish and again I was working with more chromatographic techniques including liquid chromatography mass spectrometry.
Dr Geraldine Dowling SFHEA:Ireland is important for biotoxin analysis due to significant seafood industry, particularly in shellfish farming. The country's extensive coastline and clean waters make it an ideal location for aquaculture, especially for farming mussels, oysters and other shellfish. However, these waters are also highly susceptible to harmful algal blooms, or we call them HABs, which can produce biotoxins that accumulate in shellfish and pose a risk to human health if consumed. I gotta tell you, I learned so much in those particular years in undergrad and having just graduated, and that wee small placement in my undergrad years helped me because I got more attracted to the instrumentation than what it was being used for, and so, before I knew it, I was using it in different job applications and then, from the job applications, I was getting offers of jobs and then they ended up being jobs in a particular area.
Simon:Of course. Well, you can imagine. So starting in. So this was well, 30 years ago, it was 1994. So 1994 was an interesting time, especially in toxicology and especially within analysis. And of course this is an Analytical Zen Podcast.
Simon:So let's talk about analysis. I mean, what was around in the 1990s was pretty much what was around in the 60s and 70s, you know, especially in a public funded NHS hospital lab where money was not high on the agenda of the government and we weren't awash with brand new pieces of kit but but the technology itself, to be fair, wasn't there at that particular time yet. I mean, it was literally about 1995 when I saw my first GCMS. So the perspective really was changing in the middle of a technological change, which we may talk about later when we talk in depth about analysis. But certainly my initial perspective was from technology that was older than what it should be, you know, in terms of 60s, 70s and color changes and things like that. And then over those 30 years, you know, dramatically changed with technology, with first experience of LCMS was around 2000. With accurate mass, that was around about 2010. So you know that was about 14 years ago now.
Simon:But within the job world, I mean, I started there as a medical laboratory assistant, so essentially a bench scientist, and then, after I'd done my degree and went back to work at the city hospital toxicology lab, I was a clinical scientist and I think it was important to be able to understand all the different aspects of work within a lab, from an assistant level to an analyst level to then ultimately reporting, but also, more importantly, sort of managing the labs and then being able to impart that past experience, that past knowledge on people not only you're working with but then subsequently people that are working for you, because after the hospital I actually set up my own laboratory and company and all of those past experiences really came into that. So that was, it was really beneficial.
Dr Geraldine Dowling SFHEA:That was a huge, huge jump from being someone else's employee to being your own boss.
Simon:I mean, it obviously comes with a little bit of risk anyway. I mean certainly did for me in terms of risking leaving a job that was, you know, relatively safe, etc. And and actually then, you know, going it into the private sector, which was a new thing for me. I mean, realistically, it comes down to the individual, but I really do believe that you've got to understand what you're asking other people to do as well. So don't never ask someone else to do something you won't be prepared to do yourself or have already done it yourself. Would be the best thing, of course, because you know it depends on what you're asking people to do, but it's really important that you you give them some leadership and also some explanation as to why you're doing what you're doing.
Dr Geraldine Dowling SFHEA:Simon, how have you seen drug trends evolve over the last three decades and what are some of the key challenges that you've observed?
Simon:Yes, well, there have been a massive. I mean, aside from the technology, there is this big change in drugs. If you actually go back to when I started in 94, around that 95 period, we were dealing with, again, very classical drugs. You know, it was 60s, 70s, 80s drugs. What happened in the mid 90s, though, was that there were these newfangled SSRIs selective serotonin reuptake inhibitors things like fluoxetine.
Simon:In the past, there were tricyclic antidepressants from the 70s, like amitriptyline, but in 1995, you got a growth in a number of antidepressants. There were also new antipsychotics that were introduced into the pharmaceutical marketplace, and then Viagra appeared, and that, you know, all of those drugs together suddenly introduced a big increase in the number of drugs that we were expected to be looking for, because, of course, people were taking these and in the world of clinical toxicology that I was doing as well as post-mortem toxicology people take what they have access to, and therefore, if these drugs are now available, they were being prescribed by general practitioners, by GPs, by clinics around the world. This wasn't just the UK, it was around the world. So, from a prescription drug perspective, the number of prescription drugs even then had a big leap and they're now, you know in the 2020s and every decade there's been new, new drugs, come up that have just meant that it's more of a challenge for us, for toxicologists, because back in the day you could easily just look for maybe around about 50 drugs would be typically what you might see, but now it's got to be in the hundreds and we have the capabilities of looking in the thousands, of course, through the use of accurate mass.
Simon:But yeah, the the range of prescription drugs has changed immensely. The range of prescription drugs has changed immensely. Drugs of abuse also have changed. You'll be aware, as all of your listeners will be, to the classical, so-called classical drugs of abuse in the 80s those things were added to with things like benzos, ecstasy, amphetamines, barbiturates, etc. But you know, those drugs of abuse have also expanded quite significantly into the abuse of prescription drugs, so like ketamine, for instance, but into other new designer drugs as well. That's exploded as its own entity, really, the new designer drugs.
Dr Geraldine Dowling SFHEA:Simon, how have the analytical techniques used in toxicology changed over the years, from thin layer chromatography, or TLC, to high resolution mass spectrometry, or HRMS?
Simon:Well, they have done exactly that.
Simon:And when I started in 94, 95, that was TLC, that was thin layer chromatography. I don't know if you've used it yourself, but thin layer chromatography is where you've got a silica plate where you are spotting an extract of the urine or blood that you're analyzing into a single dot, a single space on the silica plate. That's then put into a mini vat of solvent and the solvent moves up that silica plate and it takes the drugs with it and it separates them. So thin layer chromatography is that you've got a thin layer of the silica on this plate and the chromatography just means separation. But then you've got to spray it with different chemical compounds so that you can see these drugs. So you would use different types to try and show up different types of drugs, whether that be antidepressants or opiates or benzodiazepines etc.
Simon:Now TLC historically has been sort of slow in terms of you've got to dot it out and you've got to let it rise, but it also came with accidents. You know, some of the issues with TLC is that you could spend all that time plating out. We call it, you know, dotting your extract onto the plate and then if you dropped it into that, that sort of vat of solvent, at the wrong angle or something, then it wouldn't flow the way that the literature expects it to flow, because you were purely looking at where was the retention time. You know how far up the plate did it move, as well as these colour changes. So that was a problem. Now, imagine doing that at two o'clock in the morning, because that's exactly what I was doing all those years ago was doing on-call in the hospital to try and help the A&E, the accident emergency department, determine if people had overdosed or what drugs they'd taken. We'd be doing drug screens 24 hours a day, all hours, and therefore you were doing the TLC, but in conjunction with a whole load of other techniques. So, GCNPD, it's certainly important that people understand the history as well, because sometimes people do get very focused on the very latest techniques and the things that can be done in the 21st century.
Simon:But even if you go back to the 1950s and 60s, where Alan Curry was using techniques in the forensic science service and you know working with you know serious crimes and using what we would see nowadays as well, how can you rely on that in court? You know it's just a colour test. But you have to remember that a lot of these color tests and changes were chemically made so that only that compound or compound similar will make that change. So therefore, there is a degree of certainty over what you're saying. And with TLC, to an extent you had that in that there were certain sprays that you would use that would then give a certain color change. Only in the presence of opiates, only in the presence of benzodiazepines or tricyclics, etc. And even looking at rings around some of the the actual spots, you could say, oh, that's definitely that compound, because that's the only one that has a ring around it.
Simon:So yeah, it is an old technique, but the problem realistically was time. It just took too long. We were having to do this testing quickly to try and advise the doctors, maybe what antidote to give to the patient or whatever. So that's why, in parallel, you're also running additional techniques that may be a little bit quicker. So GCNPD, gas chromatography, nitrogen, phosphorus detection Many, many drugs have nitrogen in them and the concept about GCNPD is that you're using gas chromatography so you're separating these drugs within a gas phase. But if they've got nitrogen or they've got phosphorus, then they've got a chance of being detected as long as you've got the sensitivity, and because many drugs do have nitrogen in, that was a good technique of its time. But then even that was a problem because you only had retention time as your identification parameter. So we had to look for alternatives and that's why, towards the mid to late 90s, into the 2000s, that's why you're looking at these changes that have really given us more certainty over what we've found. Yes, it's helped with the actual timing, so they're quicker, but they also help with the level of certainty.
Simon:So what moved into HPLC diode array, using UV spectra as an identification tool as well. You had GCMS, of course, with mass spectrometry, which was, you know, still even now, is a very, very good technique to use. But then into the 2000s you had LCMS. So it's still mass spectrometry, but this time it was in the liquid phase. And you have to remember and this goes in in line with what I was saying about the increase in the number of pharmaceuticals many pharmaceutical companies develop drugs that they have to test themselves and often these drugs are more amenable to LC than GC. So quite often, often, that's why LC-MS is one of those techniques that's really sort of come to the fore, because many of the drugs are more amenable to LC than they are GC. So high resolution mass spectrometry was the natural evolution of LC-MS and GC-MS, whereby you're looking as accurate as possible as to what the mass is, and that will give you a much greater certainty and minimise the number of options as to what else a particular drug could be.
Dr Geraldine Dowling SFHEA:Simon, how have changes in validation example ISO accreditation, and of course there are others influence toxicology practices and laboratory operations?
Simon:Well, I mean across the world, the nature of accreditation and laboratory standards has improved. I mean, it was always there. We always had to have, of course, a level of certainty of what you found. I've just been explaining that. But you also need to understand the limitations of a method such as the limit of detection. So, classically, you do a drug screen, you don't find anything. Does that actually mean that the drug wasn't present? No, what it means is there was no drug present above your limit of detection. So then you need to know well, what is my limit of detection? So it's important to have an understanding of the limitations as much as the performance of the test that you're going to do Now.
Simon:Over time, because that is a problem that affects everybody in toxicology and in analytical toxicology around the world. Then, various people have either taken a lead in that and or organizations themselves have decided to come up with their own guidelines, which have involved those same individuals getting around the table, our peers, and utilizing, you know, good guidance that people can actually follow in a lab. So more recently you've got in America. The American Standards Board have various guidelines for the validation of methods which you can. You can use and adopt them for yourselves.
Simon:But accreditation itself doesn't always give you a defined way of doing things. You know the nature of ISO accreditation, whether that be 17025 for forensic work and measurement etc or 15189 for medical laboratories. It doesn't necessarily always tell you how to do it, but you've still got to do it. So these guidelines are really useful. But there's certainly been a move over the years, and definitely within the last 10 years, that it's an absolute minimum that when you're reporting the results you must understand the performance and the quality of the technique that you're using and, importantly, the limitations.
Dr Geraldine Dowling SFHEA:Have you had challenges with the instruments becoming just so good?
Simon:Yeah, yeah, of course. So, yes, it's not like a problem. It's a good problem to have. Yeah, you know, as you rightly say, it's a good problem to have the techniques and the technology itself has improved things right. So what has it improved? It's certainly improved timeliness. Quite often you can do things quicker than we were doing back in the day. It's also improved confidence. Yes, it's definitely that drug.
Simon:Because of X, Y and Z, because I've been able to throw three powers. You know three levels of identification at this particular substance. You know retention time it may be UV, mass, spec, etc. But yeah, the change in technology has meant that we can detect things at much, much lower levels. Now that, from an interpretation perspective I know this is an analytical podcast, but from an interpretation perspective, whenever you get the results, you've still got to say what it means effective. Whenever you get the results, you still got to say what it means. And if we did have some of those, you know modern techniques.
Simon:When, when I was doing clinical toxicology and I'm sure the current clinical toxicologists of today have the same issues, because I'm still, you know, involved in that world, in helping labs that there is a problem that, for instance urine. Back in the day, urine was something that was your go-to matrix because it was easy to handle. You had fairly high concentrations. You could see drugs even using TLC and spot tests. But now you will be able to detect drugs that someone would have used days, if not weeks, ago. So how does that help? For instance, if you're looking at cause of death, you're looking at what has someone used in the hours prior to death, not maybe what they used, you know, seven, 10 days ago and therefore you have to switch to blood. So sensitivity, yes, it does hinder the analysis in as much as you can get carry over. You do need to run more blanks, for instance, than maybe would have been done back in the day, but it also impacts on the interpretation and it's not a bad thing. It's just that we need to think about it.
Dr Geraldine Dowling SFHEA:Simon, in 2005, I published a paper on a validated method for extracting drug residues in eggs using liquid chromatography with UV spectrophotometric detection. Another thought I had was coupling an ultraviolet or UV detector with a liquid chromatograph and a mass spectrometer detector in the same instrumental setup. Have you found this combination of techniques to be useful? So, for example, have you found that the humble UV detector has been able to solve a case where the mass spec detector could not, for instance.
Simon:And you know I didn't ask you to ask me that question, but that is a perfect question for me, as people who know me will know when they listen to this podcast. Is that, yeah, UV, that's one of those techniques that I was using back in the day in those times that even today has some distinct advantages, even over mass spec, and a lot of it is to do with the. The worst is to do with the limitations of UV. Right, the limitations of UV are lack of sensitivity, but also the fact that if drugs are from the same class then they can have quite a similar UV spectrum. Now imagine where you are not quite sure the identity of a drug but you can sort of classify it and say, oh, I think that is going to be an amphetamine or I think that's going to be a benzodiazepine, because of the type of responses that you're getting from the UV.
Simon:And even in the world of modern designer drugs or new psychoactive substances, as they're called, NPS, UV has been proven over the years to be really useful for looking at the actual positional isomers, whether it's the two, three or four position of a substance, which actually MS alone, even if you've got accurate mass, will not solve because it's got the exact same empirical formula. So you may be able to solve it with retention, absolutely you can with retention time if you know what you're looking for and if you've got those standards. But with UV you could know within three seconds if it's a two or a three or four position isomer just from the nature of the UV spectrum.
Dr Geraldine Dowling SFHEA:Simon, benchtop NMR can be of significant value in other fields. However, its applications are somewhat specialised. How do you think benchtop NMR might be of value in our field?
Simon:Well, I mean benchtop NMR. So NMRs, yes, have always been massive. So benchtop is great. It will be smaller.
Simon:But realistically NMR hasn't really found its place within analytical toxicology per se because it's never really been applied to biological fluids and the reason is often because you can't recover enough of the substance for the NMR to actually characterize it. Now I remember many years ago actually it was over 20 years ago listening to a talk from Germany, where I think it was even Hans Maurer, where there was the use of NMR in diagnosing paracetamol overdoses clinically, which would be possible. So I think a benchtop NMR certainly has its place when you're looking at drug analysis, where you're looking at actual seized drug items. That will be fantastic. But from a biological fluid perspective, what we would want would say is more of a um, a smaller. You know, high resolution mass spec if possible. But that isn't always easy because the very nature of some of the techniques of high resolution you need to have, if you're using a toff, a time of flight. But for some other, like fourier transform techniques, then then you may not need that and therefore they may get smaller.
Dr Geraldine Dowling SFHEA:Okay, looking ahead, how do you see increased use of high-resolution liquid chromatography, mass spectrometry and application of machine learning and AI impacting the field of toxicology?
Simon:Yes, definitely something I'm interested in being, someone who who follows technology and and likes innovation. Um, high resolution mass spec has been a game changer within toxicology. Definitely, and, as I said, I first used it in 2010 and saw then just the power of what it can do in terms of the different sort of additions. Yes, in theory, it can replace many things it really can, but certainly if you add it along with traditional techniques, that is a very powerful thing. But where accurate mouse really comes into its own is this ability to retrospectively look at things. So that's a big plus. Many of the the techniques that we have are you get what you get at that time. You can't always go back. So, for instance, tandem mass spec, you can't go back and say, oh, was this drug there? If it wasn't in your method, you you'll never be able to say, whereas high resolution mass spec has essentially like a capture of an all-ion scenario where you find everything that's there, you've got that data and then you interrogate that data. Now that throws up some opportunities. Yes, we can interrogate it for drugs, but there are these offshoots within toxicology that have this play within biochemical toxicology, within my, you know, my qualification arena of things like metabolomics, and there's a lot of great work being done by lots of different researchers across Europe and the world around metabolomics, where that's where you're actually looking at not necessarily focusing on drugs, but you're looking on biochemical markers that may help you determine if a drug has been used, or you are looking at drug metabolites as well. So you've got chemometrics, you've got all these related techniques that come from the ability of a high resolution mass spectrometer to just basically find everything.
Simon:And then you have to throw and this is where you mentioned about AI it's very difficult for a human to sit down and click through every single peak and know exactly every mass or every MSMS, every fragmentation pattern, and go, oh, that's that. It's virtually impossible. So you really need some help. You need some machine learning, some help, and so not only does machine learning and AI does that help you interpret literally the analysis you've got in front of you, but then when you add that together with a whole load of other analyses that have taken place, for instance, you know there's been some great work presented at tiaft over the last few years around this, where, even where you're talking about people, you know being asleep, potentially at the wheel of a vehicle and being involved in an accident.
Simon:oforu can look at biochemical markers of sleep and if you, can, you know, gather that information? Can you give for want of a better word a probability that that person was tired or not? You know that is where it goes to an extreme level, but you can imagine how useful that could actually be. So bring AI, bring software capabilities into this drug world. It's not going to replace us. It's not going to replace the toxicologists per se. I think it certainly is going to help, though.
Dr Geraldine Dowling SFHEA:Yes, simon. I mean in terms of metabolomics. There are many advantages and there can be challenges, though, with inter-individual variability. As we know, I suppose the metabolic response to toxins can vary significantly between individuals due to genetic differences such as age, sex, lifestyle and other factors, and this variability then complicates the identification of universal biomarkers on toxicity.
Dr Geraldine Dowling SFHEA:Integration of the technique then with the other omics integrating, for example, metabolomics data with other omics, data like genomics, transcriptomics, proteomics, etc. This, of course, will provide a more holistic understanding of the toxicological responses. But it's extremely challenging because this all requires very sophisticated computational approaches for data integration, which is aided by machine learning, as there's vast amounts of data produced. You quite rightly state that machine learning will help us with that. You quite rightly state that machine learning will help us with that. We really do need to rely on these tools for the managing, the processing and the integrating of the data.
Dr Geraldine Dowling SFHEA:And then, of course, we're always going to need the human, because we have to translate that metabolomic data then into meaningful biological insights. Machine learning can certainly help us with that, but we need to be able to look at these biological insights in the context of toxicological mechanisms. These are quite complex. We need to determine which metabolic changes are directly related to toxicity versus those that are either adaptive or incidental, and this is very challenging.
Dr Geraldine Dowling SFHEA:What advice, simon, would you give to newcomers entering the field of toxicology, especially in light of the rapid changes?
Simon:in drug trends. Well, in light of the rapid changes of drug trends, you should be excited because it means that not every day is going to be the same as the day before. I mean, what I would say is that you've got to enjoy what you're doing. I mean, toxicology itself is, you know, we're a small, a small world. We're a small family. You know, we have 2000 around, about 2000 members in TIAFT and that covers across the world. Um, there aren't many of us. We are, we are a family.
Simon:You know, that's how I know you, Geraldine, from Ireland. You know, I wouldn't normally necessarily know you if, let's say, we were bankers. You know, we were working for a banking company. Very unlikely be able to see you in the ferrari, testa rossa or whatever you know from the 90s or something. But, um, yeah, you know it's.
Simon:It's just that toxicology is such a small world and that has an advantage. It's a family affair. You know, we all know each other. That means that we're all here to help each other. You know, and that's something I'm really, really, you know, pushed for and going to be the future president of TIAFT. I want to, you know, maintain that network, maintain that ability for people who are part of TIAFT, to know other people within TIAFT, not just in their own country but in other countries around the world, because we can all help each other. There are lots of challenges in some countries that other countries don't have, and vice versa. You know, another country may have the solution to your problem. So you know having? Uh, I would advise people to think about joining a network, think about joining an organization like TIAFT, and and others, if they have any local ones in their country.
Simon:But in terms of the day-to-day job, it's just an exciting job because if you're an analyst right, and you are that's your job. Is extracting those blood or urine samples and putting them down a piece of technology and you could see it as a oh no, I'm just doing my thousandth urine of the day and I'm looking for this. Well, what if something else is there? What if something goes wrong? You know, um, you always learn from when something is different or when something goes wrong, okay. So be excited about the something goes wrong, be excited about the. Oh, what's this? You know that I've found. I'd also say that, from an interpretation perspective, experience is everything and therefore you have to do more and more and more and just keep going, keep going and you will feel good that your own knowledge is increasing. So I would say to the future toxicologists absolutely enjoy what you're doing. You've got to want to be able to get up on a Monday morning and go. Oh yeah, I do want to go to work and you can get a lot of excitement in toxicology.
Dr Geraldine Dowling SFHEA:Simon, but nobody understands as clearly as we do because we've been in the fields for periods of time the impact it has on society and also multidisciplinary impact across those other fields. And I figured, by introducing people and public and also students who might teach about the area, you know, it might make them think, oh, actually I hadn't thought of that as a career choice. Let's go and investigate where and who to work with or how I can get that skill set, because there's going to be a shortage of our types of, of our types of professionals in the future.
Simon:class="transcript- IT is fantastic
Simon:W W W W W because we have to grow the next of toxicologists, as we call that, and there has to be a sufficient number of courses. But here's the thing, there needs to be a sufficient number of jobs waiting for those individuals afterwards. And I think it's really important for governments to understand where toxicology can help, certainly from a clinical perspective, and that goes. That's not just about emergency toxicology, like I was involved in, but therapeutic drug monitoring, or you know just the fact that we, I think also we're moving to personalized medicine and part of that is going to need a way in which we can monitor individuals, metabolism for drugs, individuals levels, concentrations, to know what is normal for that person. So therefore the dose can be
Simon:given appropriately.
Simon:And then, as you move outside of clinical into, you know, medico-legal, and over into post-mortem and forensics, where you're looking at cause of death or the impact of a drug on an individual we've got very high levels of drug driving, we've got, you know, increases, unfortunately, in drug facilitated crimes, and all this needs toxicologists to do that and therefore we need toxicology labs to be built, to be funded and to be looked after by governments and by countries, and in order to do that, it comes down to staff and having the right people. So universities are absolutely fundamental in making sure that you're encouraging those next generation of students to pass to graduate and then actually move into the job. As a toxicologist, we need you.
Dr Geraldine Dowling SFHEA:Simon in terms of memorable cases. Can you share any memorable case or experience that have particularly impacted your career? N the M S S
Simon:I'll give you one that I think exemplifies most things. So back in the summer of 1998 I'd only been in in the hospital for a few years, but I'd been working in tox for around about four years then and I was doing the analysis of poison patients, where you're looking at the urine samples of people that come to the emergency department. And there was this one case where someone had been admitted with suspected ecstasy overdose, ecstasy poisoning, and indeed there was MDMA present. But there was something else. There was something that I'd not seen before. There's something that didn't match any of the libraries that we had and it was significant. This wasn't just a minor finding, this was something significant. So I didn't think, forget about that and thought, well, okay, well, what's that? Well, literally a few weeks later there was a death of someone that died at a rave.
Simon:Now, raves, certainly at the time, were really really popular. A lot of drug use at raves, often ecstasy related. But that didn't involve ecstasy. This involved this drug that I would not seen before. So at this point I got in contact with colleagues. So again, it's all about networking. I spoke to dr les king, who was at the intelligence arm of the forensic science service drug intelligence unit and he said oh well, there is an amphetamine that uh, the netherlands had actually seen last year. Um, he arranged for, uh, that drug, uh, ms thec, to be faxed to me.
Simon:In those days you couldn't just search the internet, you know, since 1998, to have the MS faxed over, and that drug in question was called 4-methylthioamphetamine 4-MTA. It was being sold on the street as much stronger than ecstasy and over the course of that summer it killed a number of people. We had a number of deaths that I dealt with, as well as clinical intoxications. Why am I giving this as an example? I'm giving this as an example because it was the first time in which I was able to utilize HPLC-UV-Diode-A to actively, you know, confirm a drug that we've got. But it also opened up into my experience within designer drugs, because at that time there was a new organization formed in Europe called the EMCDDA, the European Monitoring Center for Drugs and Drug Addiction, and they'd just started monitoring these designer drugs. And this drug, 4mta, became a big one because you essentially had a 50-50 chance of dying. So they were very interested.
Simon:I was asked to go over to Lisbon. Now I'm, you know, essentially straight out of university. But I go over to Lisbon and give all of this information and explain about this drug and then, equally, the World Health Organization get interested, the United Nations get interested in it as well. So I go to Geneva, I go, and, you know, talk about this drug over there and then of course I'm invited to speak at different conferences and meetings and I talk to people just to let them know about it. So that was a really important experience for me because it meant that it sort of opened me up into the bigger world of networking and individuals and designer drugs. And actually that was the very first case in which I gave evidence in a coroner's inquest in cause of death back in 1998.
Dr Geraldine Dowling SFHEA:Simon, is there anything else you'd like to share on your journey in toxicology, or even about the future of the field, or even about the future of the field?
Simon:I've been lucky know Geraldine the main thing. I've been lucky even though it was an accidental way into toxicology throughout my career. I think I've had luck with me. Now, if you want to take the universe you know you said this is a Zen podcast If you want to take the universal approach to this mind, body, spirit, is that the universe saying, yeah, that's what you were meant to do? I do not know, but I do know that when I've hit, you know, these certain blocks or gates or or forks in the road, I've ended up taking the right one. So I'm pleased about that.
Simon:But in terms of toxicology itself and I just reiterate what I've already said about new people coming in really consider toxicology as a career because it delivers so much, so much more than I think some of the other typical sciences do. And it's one of those actual sciences that is combined. If you like biology, if you like chemistry, it adds to that. But then also it has a degree of pharmacology in it as well, if you pardon. The pun is that you know you've got to understand about drugs. So it widens your ability to know about medicine, to know about effects on the body and the physiology and also the psychology.
Simon:Often questions as you'll know, Geraldine, questions that we may be asked as toxicologists are well, what did that drug do to the person? Now, of course we always say and this is what you should say is that we can't say specifically on that individual, but there are some generalizations we can give. So you do need to understand sometimes there's psychological effect on people. So it really gives a whole gamut of science and that's what I would say about toxicology and it's given me lots of different opportunities and I hope others have the same in the future.
Dr Geraldine Dowling SFHEA:Simon, thank you so much for sharing your personal insights and your experience.
Simon:My pleasure. Thank you very much, Geraldine. It's lovely to speak to you.
Dr Geraldine Dowling SFHEA:It was an absolute pleasure to speak with you. Also, and to our listeners, thank you for tuning in to an episode of the Analytical Zen Podcast. Be sure to join us next time. Stay curious.