12/02/2025
A Q&A with Professor Rafael Boscolo-Berto and Assistant Professor Arianna Giorgetti, authors of the editorial „Investigating gender dynamics in forensic toxicology: The role of masculinity and femininity in alcohol and drug abuse
https://advances.umw.edu.pl/en/article/2025/34/1/5/
What are the most common misconceptions about forensics and legal medicine among the general public?
There are several misconceptions about forensic medicine that are often reinforced by the mass media.
One of the most common misunderstandings is that forensic doctors primarily work on high-profile or extremely complex homicide cases, as frequently portrayed in fictional television programs. In reality, the work of a forensic doctor encompasses a wide range of cases, including routine incidents such as drug-related crimes, traffic accidents, and suspicious deaths.
Another misconception is about the speed at which results are produced by forensic laboratories for tests like genetic analysis or toxicology. The media often suggests that DNA tests or forensic toxicology results are available instantly; however, the truth is that forensic testing can take days, weeks, or even months, depending on the complexity of the case.
Lastly, many people believe that forensic medicine is an autonomous and isolated scientific field. In fact, it involves collaboration across various disciplines, including medical, biological, and criminalistic fields. This highlights that forensic medicine is a multifaceted practice rather than a single specialty.
Are new psychoactive substances (NPS) a challenge for forensic toxicology?
Since their first introduction and discovery, NPS have posed several challenges in forensic toxicology, and these issues are still unsolved despite the evolution of technologies and methods available. Just to mention a few of them, the number of NPS, more than 1000 compounds, together with their chemical diversity, makes it impossible to have a comprehensive detection of all compounds in a single analysis, requiring differentiated and target methods, a lot of time, generous amounts of biological material and a constant update. Forensic laboratories struggle to obtain reference standards that are often antieconomic and produced or received too late to provide realistic monitoring of the NPS market and consumption. Even when technologies and references are available, and this is not the case with most routine tests performed at the emergency department, the detection of NPS remains challenging due to low stability at environmental temperature, rapid elimination with limited detection time of most molecules in blood, and the unknown metabolic biomarkers in other matrices, e.g. in urines, that usually allow wider detection frames.
In the context of issues discussed in your editorial, is there a meaningful difference between s*x [biological] and gender [cultural], or is it a marginal problem regarding these topics?
In forensic toxicology, the distinction between biological s*x and gender, or social constructs, is crucial and both concepts should be considered deeply in order to reach an accurate interpretation of the cases under investigation.
Besides biological factors that may be better understood, it is important to note that societal expectations around masculinity and femininity could influence the exposure to drugs, the context in which substances are used, the patterns of consumption, the stigma associated with drug consumption and the request for healthcare by drug users. As the gender gap narrows in some societies, an increase in women experiencing drugs, including NPS, is expected, and this might be reflected in a migration toward certain groups of NPS, e.g. designer benzodiazepines, or in more challenging intoxication cases with co-use of antidepressants and/or sedatives.
Why is gender a factor potentially impacting decision-making in post-mortem forensic toxicology?
A critical step in post-mortem forensic toxicology is represented by the choice of toxicological analyses that could apply to the case, which is, in turn, influenced by the judicial authority requests and by the amount of biological material retrieved at postmortem examination. Gender can influence the contextual factors considered during investigations, e.g., with fear of social repercussions leading to lower report of drug use in women compared to men and to the absence of an important hint for toxicological analyses.
In this context, the misconception that NPS should be searched for only in the case of male deceased, or only when there is a well-described history of abuse of conventional drugs, could prevent the detection of these substances and contribute to the underreporting of NPS fatal cases.
Advances in Clinical and Experimental Medicine (JCR impact factor = 2.1) is a peer-reviewed open a
