A case report involving repeated intoxications investigated by segmented hair analysis is presented. A 41-year-old man intoxicated his 46-year-old wife several times over half a year. During this period of time the husband went away repeatedly for some days while the wife got sick. Often when he was away, she felt dizzy and nauseated and vomited. One night she was attacked by a man, who was later identified as the husband. The Police suspected the husband for several intoxication attempts on his wife.

Hair samples were collected from the top (5cm long light brown hair with bleached stripes) and from the back of the head (2cm long light brown unbleached hair) of the wife. Hair was sampled the 15-07-2013, so two of the suspected intoxication attempts (4-4 & 13-5-2013) are represented by segment 2 (1.5–4cm). The segmented hair samples were washed, dissolved and analyzed for drugs and drugs of abuse by UPLC/TOF and quantified by UPLC/MS/MS (C. Montesano, SS. Johansen et al., JPBA 88 (2014) 295–306)

Drug findings in head hair from the scalp and back (ng/mg) are shown in the Table.
(0–1,5cm)Scalp hair(4–5cm)Back hairLOQ(1.5–4cm)(0–2cm)Caffeine1.10.42Trace1.50.10Codeine0.0090.031nd0.0120.005Lidocaine0.0090.0240.02400.0140.005Morphinend0.006ndnd0.005Tramadol0.0130.045nd0.0150.010O-desmethyltramadolTrace0.008ndTrace0.005Zolpidem0.0040.050ndTrace0.002DiazepamndNdndnd0.002Desmethyldiazepam0.002Ndndnd0.002

Segment 2 has highest drug concentrations of opioids and zolpidem. O-desmethyltramadol is a metabolite from tramadol, while morphine due to the low morphine:codeine ratio probably derives from codeine metabolism. After the violent attack the wife took diazepam a few times and the trace of the metabolite desmethyl-diazepam in the inner segment from scalp hair confirmed the ingestion. In general the drug levels in hair were low indicating few intake(s) and not sustained therapeutic use. The drug findings in the inner hair segment (0–1,5cm) were com-parable with the drug levels found in the back hair, although the back hair was not bleached. Bleaching is reported to reduce the opioid content in hair from 57 to 94%, however the scalp hair was only partly bleached suggesting a lower loss and high ability to retain the drugs.

The case illustrates that hair is a valuable forensic specimen when natural processes have eliminated the drug from typical biological specimens such as blood and urine. It was possible to verify suspected intoxications by segmented hair analysis. The husband admitted the intoxications by mixing opioids and zolpidem in the wife’ coffee. He was sentenced to prison for 6 years.