Postmortem tissue distribution of morphine and its metabolites in a series of heroin-related deaths

Drug Testing and Analysis
Peter D MaskellGiorgia De Paoli

Abstract

The abuse of heroin (diamorphine) and heroin-related deaths are increasing around the world. The interpretation of the toxicological results from suspected heroin-related deaths is notoriously difficult, especially in cases where there may be limited samples. To help forensic practitioners with heroin interpretation, we determined the concentration of morphine (M), morphine-3-glucuronide (M3G), and morphine-6-glucuronide (M6G) in blood (femoral and cardiac), brain (thalamus), liver (deep right lobe), bone marrow (sternum), skeletal muscle (psoas), and vitreous humor in 44 heroin-related deaths. The presence of 6-monoacetylmorphine (6-MAM) in any of the postmortem samples was used as confirmation of heroin use. Quantitation was carried out using a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method with solid-phase extraction. We also determined the presence of papaverine, noscapine and codeine in the samples, substances often found in illicit heroin and that may help determine illicit heroin use. The results of this study show that vitreous is the best sample to detect 6-MAM (100% of cases), and thus heroin use. The results of the M, M3G, and M6G quantitation in this study allow a degree of interpretation...Continue Reading

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Citations

May 28, 2019·Drug Testing and Analysis·Raimo A Ketola, Ilkka Ojanperä
Mar 8, 2020·International Journal of Legal Medicine·Jean-François WiartJean-Michel Gaulier
Nov 24, 2020·Journal of Forensic Sciences·Lorenzo FranceschettiCristina Cattaneo
Nov 1, 2020·Forensic Science International : Synergy·Panagoula-Stamatina A NtoupaIoannis I Papoutsis

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