The Forensic Toxicology team at NSW Health Pathology’s Forensic and Analytical Science Service (FASS) played an important role in discovering why commercially available poppy seeds led to 12 hospitalisations across NSW.
After a series of hospitalisations related to the use of large amounts of poppy seeds in November 2022, FASS scientists conducted forensic toxicology testing on blood samples from several patients and found unusually high levels of a chemical called thebaine.
Thebaine, whilst unharmful at lower doses, has been known to cause severe illness at higher levels. Symptoms of thebaine toxicity include seizures, severe muscle pains, severe muscle spasms, cramping, stiffness, dizziness, abnormal movements, or cardiac arrest.
While the first cases were detected in Queensland, agencies in Victoria led the investigation into the thebaine poisonings. FASS, in conjunction with multiple health agencies in NSW, used their expertise to increase the evidence and provided advocacy which helped lead to major supermarket chains taking poppy seeds off the shelves and issuing a recall.
FASS’s speedy investigation was made possible with cutting-edge analysers called Liquid Chromatography Quadrupole Time-of-Flight Mass Spectrometry (LC-QTOF-MS). These highly sensitive instruments detected high levels of thebaine and allowed the cross referencing with international library databases and certified reference standards available at FASS.
Forensic Toxicology Senior Scientist Catherine McDonald said that a culture of collaboration between different NSW Health agencies contributed to a successful outcome.
“Public Health works closely with food safety departments in food poisoning cases, however it’s unusual for drug investigations to lead to food safety recalls,” she said.
“Collaborative investigations between interstate Public Health departments, food authorities, poisons information centres and forensic toxicology labs was crucial in identifying the cause of illness in 37 patients around Australia.”
This collaboration was fostered by the Prescription, Recreational and Illicit Substance Evaluation (PRISE) program – a network including NSW Health Pathology’s FASS, NSW Poisons Information Centre (PIC) and the NSW Ministry of Health – which allowed for the extensive blood testing vital to the investigation.