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.

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