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

Peter D. Maskell, Nathan E. Wilson, L. Nitin Seetohul, Megan L. Crichton, Lewis J. Beer, Gail Drummond, Giorgia De Paoli*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    6 Citations (Scopus)
    69 Downloads (Pure)

    Abstract

    The abuse of heroin (diamorphine) and heroin deaths are growing around the world. The interpretation of the toxicological results from suspected heroin deaths is notoriously difficult especially in cases where there may be limited samples. In order 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 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 when samples are limited. However in some cases it may not be possible to determine heroin/morphine use as in 4 cases in muscle (3 cases in bone marrow) no morphine, morphine‐3‐glucuronide or morphine‐6‐glucuronide was detected, even though they were detected in other case samples. As always postmortem cases of suspected morphine/heroin intoxication should be interpreted with care and with as much case knowledge as possible.
    Original languageEnglish
    Pages (from-to)292-304
    Number of pages15
    JournalDrug Testing and Analysis
    Volume11
    Issue number2
    Early online date29 Aug 2018
    DOIs
    Publication statusPublished - 20 Feb 2019

    Fingerprint Dive into the research topics of 'Postmortem tissue distribution of morphine and its metabolites in a series of heroin related deaths'. Together they form a unique fingerprint.

    Cite this