Citation

Love SA, Lelinski J, Kloss J, Middleton O, Apple FS. J. Forensic Sci. 2018; 63(1): 191-194.

Affiliation

Department of Laboratory Medicine & Pathology, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN.

Copyright

(Copyright © 2018, American Society for Testing and Materials, Publisher John Wiley and Sons)

DOI

10.1111/1556-4029.13511

PMID

28422290

Abstract

Over the past two decades, prescription and illicit opioid use has led to changes in public health policy to address the increasing number of opioid-related deaths. The purpose of this study was to review cases from Hennepin County Medical Examiner's Office between 2004 through 2015 where heroin was listed as a significant contributor or as the cause of death. We identified 322 heroin-related deaths, which were predominantly male (255; 79%). 6-Monoacetylmorphine (6-MAM) median (range) concentrations were as follows: blood (n = 7), 0.010 (0.006-0.078) mg/L; urine (n = 30), 0.359 (0.009-1.75) mg/L; and vitreous humor (n = 31), 0.034 (0.004-0.24) mg/L. Free morphine was measurable in 273 cases and the percent free morphine (range), when grouped by COD, was opioid (n = 124), 28% (2.2%-92%), and mixed drug toxicity (n = 135), 35.3% (1.5%-100%); (p < 0.01). Quantitation of 6-MAM in blood and vitreous humor, along with a free to total morphine ratio >26%, was useful in establishing heroin-related deaths.

© 2017 American Academy of Forensic Sciences.

Language: en

Keywords

6-monoacetylmorphine; cause of death; forensic science; forensic toxicology; heroin; postmortem