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Concentrations of free-morphine in peripheral blood after recent use of heroin in overdose deaths and in apprehended drivers
Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Drug Research.
National Board for Forensic Medicine.
Linköping University, Department of Medical and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
2012 (English)In: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 215, no 1-3, 18-24 p.Article in journal (Refereed) Published
Abstract [en]

The concentration of free-morphine was determined in peripheral (femoral) blood from heroin-related deaths and compared with the concentration in venous blood from impaired drivers. The presence of 6-MAM in blood or urine served as a biomarker for recent use of heroin. Males dominated over females (p andlt; 0.001) in both the autopsy cases (88%) and the drivers (91%), although their mean age was about the same 33-35 y (p andgt; 0.05). Concentrations of free-morphine in blood were not associated with age of heroin users in Sweden (p andgt; 0.05). The median concentration of free-morphine was higher in autopsy cases (0.24 mg/L, N = 766) compared with apprehended drivers with 6-MAM in blood (0.15 mg/L, N = 124, p andlt; 0.05), and appreciably higher than in drivers with 6-MAM in urine but not in blood (0.03 mg/L, N = 1823, p andlt; 0.001). The free-morphine concentration was above 0.20 mg/L in 65% of autopsy cases, 36% of drivers with 6-MAM in blood but only 1.4% of drivers with 6-MAM in urine. Poly-drug deaths had about the same concentrations of free-morphine in blood (0.24 mg/L, N = 703) as heroin-only deaths (0.25 mg/L, N = 63). The concentration of morphine in drug overdose deaths (median 0.25 mg/L, N = 669) was about the same as in traumatic deaths among heroin users (0.23 mg/L, N = 97). However, the concentration of morphine was lower when the deceased had consumed alcohol (0.18 mg/L, N = 104) compared with taking a benzodiazepine (0.32 mg/L, N = 94). The concentration distributions of free-morphine in blood in heroin-related deaths overlapped with the concentrations in impaired drivers, which makes the interpretation of toxicology results difficult without knowledge about tolerance to opiates in any individual case.

Place, publisher, year, edition, pages
Elsevier , 2012. Vol. 215, no 1-3, 18-24 p.
Keyword [en]
Autopsy, Blood-alcohol, Drugs, Free-morphine, Heroin deaths, Impaired drivers, Overdose, Opiate tolerance
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-76195DOI: 10.1016/j.forsciint.2011.01.043ISI: 000300223000005OAI: diva2:513203
Available from: 2012-03-31 Created: 2012-03-30 Last updated: 2014-06-11

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Jones, A WayneAhlner, Johan
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