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Concentration ratios of free-morphine to free-codeine in femoral blood in heroin-related poisoning deaths.
MedLine Citation:
PMID:  21377914     Owner:  NLM     Status:  Publisher    
The concentrations of free-morphine (Mo), free-codeine (Co) and 6-monoacetyl morphine (6-MAM) were determined in femoral blood in N=747 heroin-related deaths. The opiates were determined by isotope dilution gas chromatography-mass spectrometry after solid-phase extraction. The median blood concentrations of 6-MAM, free-morphine and free-codeine were 0.01mg/L, 0.24mg/L and 0.02mg/L, respectively. The mean and median Mo/Co concentration ratios were 13.2 and 11.0, respectively with a range from 0.2 to 124. Despite the fact that all victims had taken heroin, there were eight cases (1.1%) with a Mo/Co ratio less than one and 18 cases (2.4%) with a ratio less than two. The free-morphine concentration in blood did not depend on the Mo/Co ratio; median 0.29mg/L (Mo/Co<2.0) and median 0.25mg/L (Mo/Co ratio>2.0). By contrast, the concentration of free-codeine in blood was highly dependent on the Mo/Co ratio; median 0.75mg/L (Mo/Co<1.0) and median 0.30mg/L (Mo/Co ratio<2.0). A Mo/Co ratio in post-mortem (PM) femoral blood >1.0 is compelling evidence that the deceased had taken illicit heroin. However, finding a low Mo/Co ratio (<1.0 or <2.0) does not preclude use of heroin because such low ratios are possible if a person had co-ingested heroin along with use or abuse of codeine medication.
A Wayne Jones; Anita Holmgren
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-4
Journal Detail:
Title:  Legal medicine (Tokyo, Japan)     Volume:  -     ISSN:  1873-4162     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100889186     Medline TA:  Leg Med (Tokyo)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Artillerigatan 12, SE-587 58 Linköping, Sweden.
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