Postmortem Blood Free and Total Morphine Concentrations in Medical Examiner Cases

    Volume 46, Issue 5 (September 2001)

    ISSN: 0022-1198

    CODEN: JFSOAD

    Page Count: 5


    Apple, FS
    Medical pathology resident, University of Minnesota, Lab Medicine and Pathology, Minneapolis, MN

    Kloss, J
    Medical director, Clinical Labs, and supervisor, Tox Lab, Hennepin County Medical Center, Clinical Laboratories 812, Minneapolis, MN

    Burt, MJ
    Medical director, Clinical Labs, and supervisor, Tox Lab, Hennepin County Medical Center, Clinical Laboratories 812, Minneapolis, MN

    (Received 6 July 2000; accepted 9 October 2000)

    Abstract

    This purpose of this study was to determine the relationships between postmortem free morphine and total morphine levels in a large series of medical examiner morphine and heroin related deaths. Free morphine, total morphine, and 6-monoacetylmorphine (6-MAM) concentrations were measured by gas chromatography-mass spectrometry (GC-MS) in 87 medical examiner cases over 20 months. The mean total morphine concentration, mean free morphine concentration, and mean percent free morphine for all cases were: 2.3 mg/L (SD 5.2 mg/L), 0.5 mg/L (SD 1.6 mg/L), and 19.4% (SD 22.8%); respectively. Regression analyses showed weak correlations between total and free morphine concentrations over the entire concentration range (0 to 36.6 mg/L, r = 0.603, n = 91) and over a subset concentration range of 0 to 1.0 mg/L (r = 0.369, n = 54). Twenty-three out of 56 (41%) tested positive for 6-MAM, indicative heroin abuse cases. Lower total and free morphine concentrations and a higher percent free morphine were found in individuals with detectable 6-MAM. Comparing blood concentrations for cases with and without detectable 6-MAM demonstrated mean total morphine concentrations of 0.9 mg/L versus 2.1 mg/L (p = 0.05), mean free morphine concentrations of 0.3 mg/L versus 0.4 mg/L (p = 0.21), and mean percent free morphine of 34.7% versus 13.7% (p < 0.003), respectively. Our findings demonstrate higher free to total morphine ratios in individuals with detectable 6-MAM than in individuals without 6-MAM. The database established in this study may assist medical examiners in the evaluation of postmortem blood opiates regarding the cause of death in opiate related ingestion cases.


    Paper ID: JFS15112J

    DOI: 10.1520/JFS15112J

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    Author
    Title Postmortem Blood Free and Total Morphine Concentrations in Medical Examiner Cases
    Symposium , 0000-00-00
    Committee E30