Post-Mortem Analysis of Heroin Biomarkers, Morphine and Codeine in Stomach Wall Tissue in Heroin-Related Deaths
Abstract
:1. Introduction
2. Materials and Methods
2.1. Chemicals and Reference Standards
2.2. Case Samples
2.2.1. Inclusion/Exclusion Criteria
2.2.2. Sample Collections
2.2.3. Data Collection
2.2.4. Toxicological Testing
2.2.5. Stomach Wall Tissue Sample Preparation
2.2.6. Preparation of Other Postmortem Matrices
2.2.7. Solid-Phase Extraction
2.3. Instrumentation
2.4. Method Validation
2.5. Statistical Analysis
3. Results
3.1. Method Validation
3.2. Case Samples
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Al-Asmari, A.I. Postmortem Fluid Concentrations of Heroin Biomarkers and Their Metabolites. J. Forensic Sci. 2020, 65, 570–579. [Google Scholar] [CrossRef] [PubMed]
- Skopp, G. Preanalytic Aspects in Postmortem Toxicology. Forensic Sci. Int. 2004, 142, 75–100. [Google Scholar] [CrossRef] [PubMed]
- Moffat, A.C.; Osselton, M.D.; Widdop, B. Clarke’s Analysis of Drugs and Poisons in Pharmaceuticals, Body Fluids and Postmortem Material, 4th ed.; Pharmaceutical Press: London, UK, 2011; pp. 1225–1227. [Google Scholar]
- Skopp, G. Postmortem Toxicology. Forensic Sci. Med. Pathol. 2010, 6, 314–325. [Google Scholar] [CrossRef] [PubMed]
- Randall, B. Disposition of Toxic Drugs and Chemicals in Man, 8th ed.; Biomedical Publications: Foster City, CA, USA, 2008; pp. 532–536. [Google Scholar]
- Al-Asmari, A.I. Postmortem Liver and Kidney Tissue Concentrations of Heroin Biomarkers and Their Metabolites in Heroin-Related Fatalities. J. Forensic Sci. 2020, 65, 2087–2093. [Google Scholar] [CrossRef] [PubMed]
- Felby, S.; Christensen, H.; Lund, A. Morphine Concentrations in Blood and Organs in Cases of Fatal Poisoning. Forensic Sci. 1974, 3, 77–81. [Google Scholar] [CrossRef]
- Maskell, P.D.; Wilson, N.E.; Seetohul, L.N.; Crichton, M.L.; Beer, L.J.; Drummond, G.; de Paoli, G. Postmortem Tissue Distribution of Morphine and Its Metabolites in a Series of Heroin-Related Deaths. Drug Test. Anal. 2019, 11, 292–304. [Google Scholar] [CrossRef]
- Margalho, C.; Franco, J.; Corte-Real, F.; Vieira, D.N. Illicit Drugs in Alternative Biological Specimens: A Case Report. J. Forensic Leg. Med. 2011, 18, 132–135. [Google Scholar] [CrossRef]
- Thaulow, C.H.; Øiestad, Å.M.L.; Rogde, S.; Karinen, R.; Brochmann, G.W.; Andersen, J.M.; Høiseth, G.; Handal, M.; Mørland, J.; Arnestad, M.; et al. Metabolites of Heroin in Several Different Post-Mortem Matrices. J. Anal. Toxicol. 2018, 42, 311–320. [Google Scholar] [CrossRef]
- Vandenbosch, M.; Pajk, S.; van den Bogaert, W.; Wuestenbergs, J.; van de Voorde, W.; Cuypers, E. Post-Mortem Analysis of Opioids and Metabolites in Skeletal Tissue. J. Anal. Toxicol. 2021. [Google Scholar] [CrossRef]
- Thaulow, C.H.; Øiestad, Å.M.L.; Rogde, S.; Andersen, J.M.; Høiseth, G.; Handal, M.; Mørland, J.; Vindenes, V. Can Measurements of Heroin Metabolites in Post-Mortem Matrices Other than Peripheral Blood Indicate If Death Was Rapid or Delayed? Forensic Sci. Int. 2018, 290, 121–128. [Google Scholar] [CrossRef]
- Thiblin, I.; Eksborg, S.; Petersson, A.; Fugelstad, A.; Rajs, J. Fatal Intoxication as a Consequence of Intranasal Administration (Snorting) or Pulmonary Inhalation (Smoking) of Heroin. Forensic Sci. Int. 2004, 139, 241–247. [Google Scholar] [CrossRef] [PubMed]
- Havig, S.M.; Vindenes, V.; Øiestad, Å.M.L.; Rogde, S.; Thaulow, C.H. Methadone, Buprenorphine, Oxycodone, Fentanyl and Tramadol in Multiple Postmortem Matrices. J. Anal. Toxicol. 2021, 46, 600–610. [Google Scholar] [CrossRef] [PubMed]
- Chaturvedi, A.K.; Rao, N.G.S.; Baird, J.R. A Death Due to Self-Administered Fentanyl. J. Anal. Toxicol. 1990, 14, 385–387. [Google Scholar] [CrossRef] [PubMed]
- Moriya, F.; Hashimoto, Y. Distribution of Free and Conjugated Morphine in Body Fluids and Tissues in a Fatal Heroin Overdose: Is Conjugated Morphine Stable in Postmortem Specimens? J. Forensic Sci. 1997, 42, 736–740. [Google Scholar] [CrossRef]
- Uboh, C.E.; Rudy, J.A.; Railing, F.A.; Enright, J.M.; Shoemaker, J.M.; Kahler, M.C.; Shellenberger, J.M.; Kemecsei, Z.; Das, D.N.; Soma, L.R.; et al. Postmortem Tissue Samples: An Alternative to Urine and Blood for Drug Analysis in Racehorses. J. Anal. Toxicol. 1995, 19, 307–315. [Google Scholar] [CrossRef]
- Levine, W.G. Biliary Excretion of Drugs and Other Xenobiotics. Annu. Rev. Pharmacol. Toxicol. 1978, 18, 81–96. [Google Scholar] [CrossRef]
- Duflou, J.; Darke, S.; Easson, J. Morphine Concentrations in Stomach Contents of Intravenous Opioid Overdose Deaths. J. Forensic Sci. 2009, 54, 1181–1184. [Google Scholar] [CrossRef]
- Jones, A.W.; Holmgren, A.; Ahlner, J. Concentrations of Free-Morphine in Peripheral Blood after Recent Use of Heroin in Overdose Deaths and in Apprehended Drivers. Forensic Sci. Int. 2012, 215, 18–24. [Google Scholar] [CrossRef]
- Jones, A.W.; Holmgren, A. Concentration Ratios of Free-Morphine to Free-Codeine in Femoral Blood in Heroin-Related Poisoning Deaths. Leg. Med. 2011, 13, 171–173. [Google Scholar] [CrossRef]
- Al-Asmari, A.I.; Anderson, R.A. Method for Quantification of Opioids and Their Metabolites in Autopsy Blood by Liquid Chromatography-Tandem Mass Spectrometry. J. Anal. Toxicol. 2007, 31, 394–408. [Google Scholar] [CrossRef]
- Jakobsson, G.; Truver, M.T.; Wrobel, S.A.; Gréen, H.; Kronstrand, R. Heroin-Related Compounds and Metabolic Ratios in Postmortem Samples Using LC-MS-MS. J. Anal. Toxicol. 2021, 45, 215–225. [Google Scholar] [CrossRef]
- Bidny, S.; Gago, K.; Chung, P.; Albertyn, D.; Pasin, D. Simultaneous Screening and Quantification of Basic, Neutral and Acidic Drugs in Blood Using UPLC-QTOF-MS. J. Anal. Toxicol. 2017, 41, 181–195. [Google Scholar] [CrossRef] [PubMed]
- Di Rago, M.; Saar, E.; Rodda, L.N.; Turfus, S.; Kotsos, A.; Gerostamoulos, D.; Drummer, O.H. Fast Targeted Analysis of 132 Acidic and Neutral Drugs and Poisons in Whole Blood Using LC-MS/MS. Forensic Sci. Int. 2014, 243, 35–43. [Google Scholar] [CrossRef] [PubMed]
- Al-Asmari, A.I. Method for the Identification and Quantification of Sixty Drugs and Their Metabolites in Postmortem Whole Blood Using Liquid Chromatography Tandem Mass Spectrometry. Forensic Sci. Int. 2020, 309, 110193. [Google Scholar] [CrossRef] [PubMed]
- Maurer, H.H. Chapter 12 Forensic Screening with GC-MS. Handb. Anal. Sep. 2008, 6, 425–445. [Google Scholar] [CrossRef]
- Wylie, F.M.; Torrance, H.; Seymour, A.; Buttress, S.; Oliver, J.S. Drugs in Oral Fluid: Part II. Investigation of Drugs in Drivers. Forensic Sci. Int. 2005, 150, 199–204. [Google Scholar] [CrossRef]
- Peters, F.T.; Drummer, O.H.; Musshoff, F. Validation of New Methods. Forensic Sci. Int. 2007, 165, 216–224. [Google Scholar] [CrossRef]
- American Academy of Forensic Sciences Standards Board 2019. In ANSI/ASB Standard 036; Method Validation in Forensic Toxicology; Springs: Colorado, CO, USA, 2019.
- DeRienz, R.T.; Baker, D.D.; Kelly, N.E.; Mullins, A.M.; Barnett, R.Y.; Hobbs, J.M.; Daniels, J.A.; Harshbarger, K.E.; Ortiz, A.M. Child Fatalities Due to Heroin/Fentanyl Exposure: What the Case History Missed. J. Anal. Toxicol. 2018, 42, 581–585. [Google Scholar] [CrossRef]
- Wyman, J.; Bultman, S. Postmortem Distribution of Heroin Metabolites in Femoral Blood, Liver, Cerebrospinal Fluid, and Vitreous Humor. J. Anal. Toxicol. 2004, 28, 260–263. [Google Scholar] [CrossRef]
- Crandall, C.S.; Kerrigan, S.; Aguero, R.L.; LaValley, J.; McKinney, P.E. The Influence of Collection Site and Methods on Postmortem Morphine Concentrations in a Porcine Model. J. Anal. Toxicol. 2006, 30, 651–658. [Google Scholar] [CrossRef]
- Al-Asmari, A.I.; Altowairgi, M.M.; Al-Amoudi, D.H. Effects of Postmortem Interval, Putrefaction, Diabetes, and Location of Death on the Analysis of Ethyl Glucuronide and Ethyl Sulfate as Ethanol Biomarkers of Antemortem Alcohol Consumption. Forensic Sci. Int. 2022, 335, 111280. [Google Scholar] [CrossRef] [PubMed]
- Butzbach, D.M. The Influence of Putrefaction and Sample Storage on Post-Mortem Toxicology Results. Forensic Sci. Med. Pathol. 2010, 6, 35–45. [Google Scholar] [CrossRef] [PubMed]
- Rees, K.A.; Pounder, D.J.; Osselton, M.D. Distribution of Opiates in Femoral Blood and Vitreous Humour in Heroin/Morphine-Related Deaths. Forensic Sci. Int. 2013, 226, 152–159. [Google Scholar] [CrossRef]
- Gerostamoulos, J.; Drummer, O.H. Postmortem Redistribution of Morphine and Its Metabolites. J. Forensic Sci. 2000, 45, 843–845. [Google Scholar] [CrossRef]
- Fugelstad, A.; Ahlner, J.; Brandt, L.; Ceder, G.; Eksborg, S.; Rajs, J.; Beck, O. Use of Morphine and 6-Monoacetylmorphine in Blood for the Evaluation of Possible Risk Factors for Sudden Death in 192 Heroin Users. Addiction 2003, 98, 463–470. [Google Scholar] [CrossRef] [PubMed]
- Maskell, P.D.; Albeishy, M.; de Paoli, G.; Wilson, N.E.; Seetohul, L.N. Postmortem Redistribution of the Heroin Metabolites Morphine and Morphine-3-Glucuronide in Rabbits over 24 h. Int. J. Leg. Med. 2016, 130, 519–531. [Google Scholar] [CrossRef] [PubMed]
- Goldberger, B.A.; Cone, E.J.; Grant, T.M.; Levine, B.S.; Smialek, J.E. Disposition of Heroin and Its Metabolites in Heroin-Related Deaths. J. Anal. Toxicol. 1994, 18, 22–28. [Google Scholar] [CrossRef]
Analytes & | Internal Standards | Retention Time (min) | Quantifier | Qualifier |
---|---|---|---|---|
6-MAM | 6-MAM-d3 | 6.85 | m/z = 328–165 | m/z = 328–221 |
6-MAM-d3 # | - | 6.95 | m/z = 331–165 | m/z = 331–221 |
6-AC | Codeine-d3 | 9.3 | m/z = 342–225 | m/z = 342–165 |
Morphine | Morphine-d3 | 4.7 | m/z = 286–165 | m/z = 286–153 |
Morphine-d3 # | - | 4.6 | m/z = 289–165 | m/z = 289–153 |
Codeine | Codeine-d3 | 6.8 | m/z = 300–165 | m/z = 300–44 |
Codeine-d3 # | - | 6.7 | m/z = 303–165 | m/z = 300–199 |
Analytes | ||||||
---|---|---|---|---|---|---|
6-Monoacetylmorphine | Morphine | 6-Acetylcodeine | Codeine | |||
Linearity (10 different days, 5 replicate/control) | R2 * | 0.999 | 0.999 | 0.999 | 0.999 | |
LDR Φ (ng/g) | 0.5–1000.0 | 0.5–1000.0 | 0.5–1000.0 | 0.5–1000.0 | ||
Intercept | 0.4488028 | −0.0063087 | −0.044456 | 0.0756881 | ||
STDEV # (intercept) | 0.0036603 | 0.000405 | 0.001627 | 0.0006525 | ||
Slope | 0.045315 | 0.005116 | 0.013986 | 0.013706 | ||
Sensitivity (ng/g) | Limit of detection | 0.3 | 0.3 | 0.4 | 0.2 | |
Limit of quantification | 1.0 | 1.0 | 1.0 | 1.0 | ||
Upper limit of quantification | 1000.0 | 1000.0 | 1000.0 | 1000.0 | ||
Accuracy and precision | Low control (5 ng/g) | Mean (ng/g) | 5.0 | 5.1 | 5.1 | 4.9 |
STDEV | 0.2 | 0.3 | 0.4 | 0.3 | ||
%E Ҿ | −1 | 3 | 2 | −3 | ||
Within-run%CV ** | 5 | 5 | 8 | 3 | ||
Between-run%CV | 5 | 7 | 7 | 6 | ||
Medium Control (100 ng/g) | Mean (ng/g) | 96.1 | 100.9 | 103.1 | 101.0 | |
%E | −4 | 1 | 3 | 1 | ||
Within Run%CV | 4 | 4 | 5 | 5 | ||
Between Run%CV | 6 | 5 | 8 | 7 | ||
High control (800 ng/g) | Mean (ng/g) | 790.3 | 811.4 | 808.0 | 789.8 | |
%E | −1 | 1 | 1 | −1 | ||
Within Run%CV | 2 | 2 | 5 | 1 | ||
Between Run%CV | 2 | 3 | 4 | 2 | ||
Dilution | Dilution low control Ψ (250 ng/g) | Mean (ng/g) | 4.8 | 5.2 | 4.8 | 4.8 |
%E | −2 | 2 | −2 | −2 | ||
Within-run%CV | 3 | 6 | 5 | 5 | ||
Between-run%CV | 4 | 7 | 4 | 5 | ||
Dilution High control ¥ (7500 ng/g) | Mean (ng/g) | 76.8 | 73.2 | 70.5 | 74.3 | |
%E | 2 | −2 | −6 | −1 | ||
Within-run%CV | 7 | 9 | 5 | 5 | ||
Between-run%CV | 9 | 9 | 9 | 7 | ||
Matrix effects (%) | 5 ng/g | Mean (ng/g) | −19 | 14 | −20 | 17 |
%CV | 6 | 11 | 7 | 13 | ||
Recovery (%) | Mean (ng/g) | 78 | 80 | 76 | 79 | |
%CV | 10 | 5 | 4 | 2 | ||
Matrix effects (%) | 100 ng/g | Mean (ng/g) | −15 | 8 | −8 | 4 |
%CV | 12 | 7 | 4 | 8 | ||
Recovery (%) | Mean (ng/g) | 82 | 84 | 82 | 91 | |
%CV | 3 | 5 | 6 | 4 | ||
Matrix effects (%) | 800 ng/g | Mean (ng/g) | −5 | 2 | −4 | 2 |
%CV | 6 | 3 | 3 | 5 | ||
Recovery (%) | Mean (ng/g) | 94 | 92 | 94 | 94 | |
%CV | 7 | 5 | 8 | 5 |
Case no. | History | Age | Putrefaction | Other Drugs | |
---|---|---|---|---|---|
1. | The deceased was found dead in his home | 44 | None | None | |
2. | The deceased found dead under a bridge, and the deceased was a heroin abuser | 29 | Heavy | Amphetamine | BNaF *: 91 ng/mL |
3. | The deceased died inside a house; drug use was suspected, as there were needles and empty plastic bags next to the body | 56 | Heavy | None | |
4. | The deceased was found dead in a desert area | 31 | Heavy | None | |
5. | The deceased was found dead at home | 70 | Some | None | |
6. | The deceased had a history of mental illness and drug abuse | 26 | None | None | |
7. | The deceased was found dead in a car with no traces of violence or wounds. The deceased had a history of heroin addiction | 46 | Some | Alprazolam | BNaF: 30 ng/mL |
11-nor-Delta-9-Tetrahydrocannabinol (THC-COOH) | BNaF: 12 ng/mL | ||||
8. | The body of the deceased was found in a desert land with traces of acupuncture | 25 | None | None | |
9. | The body was found in the downtown area, and was in a highly decomposed condition | 33 | Heavy | None | |
10. | The body of the deceased was found in a desert land with traces of acupuncture | 30 | None | Amphetamine | BNaF: 450 ng/mL ST-W&: 845 ng/g Liver: 400 ng/g Kidneys: 800 ng/g |
11. | Syringes and needles were found next to the body | 43 | Some | None | |
12. | The deceased died with two people in a house. Drugs were found in the house | 23 | None | Cocaine | BNaF: 0.5 ng/mL Gastric content: 5 ng/mL |
Benzoylecgonine | BNaF: 5 ng/mL Liver: 30 ng/g | ||||
Ecgonine methyl ester | BNaF: 19 ng/mL Gastric contents: 43 ng/mL ST-W: 25 ng/g Liver: 20 ng/g Kidney 30 ng/g | ||||
Delta-9-Tetrahydrocannabinol (THC) | BNaF: 11 ng/mL Gastric contents: 121 ng/mL ST-W; 5 ng/g | ||||
11-hydroxy-delta-9-THC (THC-OH) | BNaF: 3 ng/mL | ||||
THC-COOH | BNaF: 17 ng/mL ST-W; 6 ng/g Liver: 40 ng/g Kidneys: 50 ng/g | ||||
Alprazolam, | BNaF: 29 ng/mL Gastric contents: 780 ng/mL ST-W; 115 ng/g Liver: 55 ng/g Kidneys: 25 ng/g | ||||
Pregabalin | BNaF: 610 ng/mL Gastric contents: 14,000 ng/mL ST-W; 1900 ng/g Liver: 1020 ng/g Kidneys: 1150 ng/g | ||||
13. | The deceased died with two people in a house. Drugs were found in the house | 23 | None | THC | BNaF: 20 ng/mL Gastric contents: 170 ng/mL |
THC-OH | BNaF: 8 ng/mL | ||||
THC-COOH | BNaF: 92 ng/mL Gastric contents: 170 ng/mL ST-W; 30 ng/g Liver: 90 ng/g Kidneys: 60 ng/g | ||||
Alprazolam, | BNaF: 43 ng/mL Gastric contents: 62 ng/mL ST-W; 15 ng/g Liver: 7 ng/g Kidneys: 3 ng/g | ||||
Tramadol | BNaF: 57 ng/mL Gastric contents: 112 ng/mL ST-W; 150 ng/g Liver: 145 ng/g Kidneys: 140 ng/g | ||||
14. | The deceased died with two people in a house. Drugs were found in the house | 21 | None | THC | BNaF: 10 ng/mL Gastric contents: 5 ng/mL Liver: 5 ng/g |
THC-OH | BNaF: 4 ng/mL | ||||
THC-COOH | BNaF: 18 ng/mL Gastric contents: 25 ng/mL Liver: 55 ng/g Kidneys: 60 ng/g | ||||
Alprazolam, | BNaF: 2 ng/mL Gastric contents: 1 ng/mL Liver: 6 ng/g Kidneys: 3 ng/g | ||||
Tramadol | BNaF: 40 ng/mL Gastric contents: 37 ng/mL ST-W; 160 ng/g Liver: 95 ng/g Kidneys: 135 ng/g | ||||
15. | The deceased was found dead in a car in the front passenger seat | 45 | Some | Ethanol | BNaF: 162 mg/dL Gastric contents: 350 mg/dL ST-W; 3.52 mg/g Liver: 6.15 mg/g Kidneys: 4.30 mg/g |
Ethyl glucuronide | BNaF: 14,300 ng/mL | ||||
Ethyl sulfate | BNaF: 4100 ng/mL | ||||
Amphetamine | BNaF: 310 ng/mL Gastric contents: 550 ng/mL ST-W; 380 ng/g Liver: 210 ng/g Kidneys: 160 ng/g | ||||
16. | The deceased was found dead at home with several sizes of syringes next to him. Death as a result of a heroin overdose | 35 | Some | None |
Blood with Sodium Fluoride | Gastric Contents | Stomach Wall Tissues | Liver Tissues | Kidneys Tissues | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
(ng/mL) | (ng/mL) | (ng/g) | (ng/g) | (ng/g) | ||||||||||||||||
Case no. | 6-MAM ϕ | 6-AC λ | MOR Ҿ | COD Ҕ | 6-MAM | 6-AC | MOR | COD | 6-MAM | 6-AC | MOR | COD | 6-MAM | 6-AC | MOR | COD | 6-MAM | 6-AC | MOR | COD |
1 | n.a * | n.a | n.a | n.a | n.a | n.a | n.a | n.a | 84 | neg # | 247 | 16 | neg | neg | 755 | n.a. | n.a. | n.a. | n.a. | n.a. |
2 | n.a | n.a | n.a | n.a | 397 | 11 | 72 | 39 | 35 | 2 | 75 | 30 | neg | neg | 80 | 10 | neg | neg | 95 | 9 |
3 | n.a | n.a | n.a | n.a | n.a | n.a | n.a | n.a | 138 | neg | 931 | 39 | neg | neg | 1031 | 28 | 4 | neg | 598 | 28 |
4 | n.a | n.a | n.a | n.a | n.a | n.a | n.a | n.a | 170 | neg | 160 | 24 | neg | neg | 650 | 17 | neg | neg | 535 | 21 |
5 | 25 | neg | 78 | 5 | 328 | 65 | 29 | 41 | 329 | neg | 29 | 41 | n.a. | n.a. | n.a. | n.a. | 288 | neg | 1930 | 19 |
6 | 5 | neg | 16 | 13 | 409 | 272 | 70 | 232 | 30 | neg | 11 | 9 | 2 | neg | 167 | n.a. | n.a. | n.a. | n.a. | |
7 | neg | neg | 205 | 20 | neg | neg | 366 | 58 | neg | neg | 66 | 18 | neg | neg | 268 | 13 | n.a. | n.a. | n.a. | n.a. |
8 | 12 | neg | 467 | 23 | 165 | 97 | 29 | 40 | 89 | neg | 115 | neg | neg | 810 | 50 | neg | neg | 1400 | 70 | |
9 | 17 | neg | 715 | 44 | n.a | n.a | n.a | n.a | neg | neg | 410 | 55 | neg | neg | 395 | 18 | neg | neg | 3485 | 95 |
10 | neg | neg | 172 | 16 | n.a | n.a | n.a | n.a | neg | neg | 230 | 45 | neg | neg | 200 | 9 | neg | neg | 270 | 25 |
11 | 55 | 12 | 26 | 4 | 66 | 25 | 122 | 14 | neg | neg | 50 | 5 | neg | neg | 120 | 6 | neg | neg | 110 | 8 |
12 | 1 | 5 | 102 | 10 | 88 | 44 | 34 | 20 | 15 | neg | 55 | 5 | neg | neg | 160 | 10 | neg | neg | 250 | 10 |
13 | 3 | 3 | 286 | 39 | 661 | 376 | 440 | 92 | 60 | 55 | 240 | 35 | neg | neg | 300 | 30 | neg | neg | 338 | 30 |
14 | 1 | 1 | 98 | 10 | 105 | 134 | 481 | 25 | 190 | 320 | 1300 | 70 | neg | neg | 80 | 10 | 2 | neg | 505 | 20 |
15 | 24 | 2 | 196 | 22 | 66 | 5 | 252 | 26 | 10 | 20 | 85 | 10 | neg | neg | 25 | 3 | neg | neg | 180 | 4 |
16 | neg | neg | 255 | 54 | 722 | 103 | 416 | 240 | 485 | 5 | 1100 | 260 | neg | neg | 118 | 20 | neg | neg | 140 | 26 |
Mean | 15.9 | 4.6 | 218.0 | 21.7 | 300.7 | 113.2 | 210.1 | 75.2 | 136.3 | 80.4 | 319.0 | 44.1 | n.a. | n.a. | 343.9 | 16.9 | 98.0 | n.a. | 756.6 | 28.1 |
Median | 12.0 | 3.0 | 184.0 | 18.0 | 246.5 | 81.0 | 122.0 | 40.0 | 86.5 | 20.0 | 137.5 | 30.0 | n.a. | n.a. | 200.0 | 13.0 | 4.0 | n.a. | 338.0 | 21.0 |
STDEV | 17.4 | 4.4 | 200.7 | 16.0 | 245.2 | 121.2 | 183.8 | 82.3 | 143.3 | 135.6 | 411.6 | 62.7 | n.a. | n.a. | 315.1 | 12.9 | 164.5 | n.a. | 983.6 | 26.0 |
Min | 1.0 | 1.0 | 16.0 | 4.0 | 66.0 | 5.0 | 29.0 | 14.0 | 10.0 | 2.0 | 11.0 | 5.0 | n.a. | n.a. | 25.0 | 3.0 | 2.0 | n.a. | 95.0 | 4.0 |
Max | 55.0 | 12.0 | 715.0 | 54.0 | 722.0 | 376.0 | 481.0 | 240.0 | 485.0 | 320.0 | 1300.0 | 260.0 | n.a. | n.a. | 1031.0 | 50.0 | 288.0 | n.a. | 3485.0 | 95.0 |
6-MAM ϕ: 6-Monoacetylmorphine; 6-AC λ: 6-Acetylcodeine; MOR Ҿ: Morphine; COD Ҕ: Codeine; STDEV, standard deviation; n.a *: Sample not available; neg #: Negative. |
Specimens | Blood with Sodium Fluoride | Gastric Contents | Stomach Wall Tissues | Liver Tissues | Kidneys Tissues | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Analyes & | 6-MAM | 6-AC | MOR | COD | 6-MAM | 6-AC | MOR | COD | 6-MAM | 6-AC | MOR | COD | 6-MAM | 6-AC | MOR | COD | 6-MAM | 6-AC | MOR | COD | |
Blood with sodium fluoride | 6-MAM | 1 | |||||||||||||||||||
6-AC | 0.6 ** [0.3] | 1 | |||||||||||||||||||
MOR | −0.240 [0.6] | −0.3 [0.6] | 1 | ||||||||||||||||||
COD | −0.350 [0.4] | −0.451 [0.4] | 0.872 [0.0002] * | 1 | |||||||||||||||||
Gastric Contents | 6-MAM | −0.300 [0.5] | −0.6 [0.3] | 0.251 [0.5] | 0.621 [0.07] | 1 | |||||||||||||||
6-AC | −0.510 [0.2] | −0.6 [0.3] | 0.120 [0.8] | 0.451 [0.2] | 0.650 [0.04] * | 1 | |||||||||||||||
MOR | −0.350 [0.4] | −0.800 [0.1] | 0.200 [0.6] | 0.341 [0.3] | 0.130 [0.7] | 0.300 [0.4] | 1 | ||||||||||||||
COD | −0.050 [0.9] | (−0.6) [0.3] | 0.300 [0.4] | 0.670 [0.03] * | 0.900 [0.0004] * | 0.600 [0.07] | 0.140 [0.7] | 1 | |||||||||||||
Stomach wall tissues | 6-MAM | 0.071 [0.8] | −0.400 [0.6] | 0.200 [0.7] | 0.200 [0.7] | 0.520 [0.2] | 0.400 [0.3] | 0.100 [0.8] | 0.470 [0.2] | 1 | |||||||||||
6-AC | n.a. | 0.820 [0.09] | 0.300 [0.6] | 0.100 [0.9] | 0.500 [0.4] | 0.600 [0.3] | 0.900 [0.04] * | −0.500 [0.4] | 0.200 [0.7] | 1 | |||||||||||
MOR | −0.45 [0.2] | −0.900 [0.03] * | 0.040 [0.9] | 0.537 [0.9] | 0.200 [0.6] | 0.300 [0.5] | 0.700 [0.03] * | 0.500 [0.1] | 0.531 [0.08] | 0.700 [0.2] | 1 | ||||||||||
COD | −0.3 [0.5] | −0.872 [0.05] | 0.350 [0.3] | 0.711 [0.02] * | 0.600 [0.09] | 0.400 [0.3] | 0.100 [0.8] | 0.668 [0.03] | 0.863 [0.0006] * | 0.200 [0.7] | 0.702 [0.004] * | 1 | |||||||||
Liver tissues | 6-MAM | n.a. | n.a | n.a | n.a | n.a | n.a | n.a | n.a | n.a | n.a | n.a | n.a | 1 | |||||||
6-AC | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a | 1 | |||||||
MOR | −0.050 [0.9] | 0.5 [0.4] | 0.200 [0.6] | 0.200 [0.6] | 0.352 [0.4] | 0.600 [0.08] | −0.300 [0.4] | 0.360 [0.3] | 0.300 [0.4] | 0.100 [0.9] | 0.200 [0.5] | 0.100 [0.8] | n.a. | n.a | 1 | ||||||
COD | −0.381 [0.4] | −0.050 [0.9] | 0.800 [0.01] * | 0.700 [0.03] * | 0.650 [0.08] | 0.800 [0.01] * | 0.100 [0.8] | 0.664 [0.05] | 0.420 [0.3] | 0.300 [0.6] | 0.500 [0.09] | 0.500 [0.1] | n.a. | n.a. | 0.864 [0.0001] * | 1 | |||||
Kidneys tissues | 6-MAM | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a | n.a | 1 | |||
6-AC | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a | 1 | |||
MOR | 0.120 [0.8] | −0.700 [0.2] | 0.433 [0.2] | 0.150 [0.7] | 0.050 [0.9] | 0.520 [0.2] | −0.242 [0.5] | 0.250 [0.5] | 0.381 [0.3] | 0.700 [0.2] | 0.210 [0.5] | 0.381 [0.2] | n.a. | n.a. | 0.760 [0.004] * | 0.700 [0.02] * | n.a. | n.a | 1 | ||
COD | 0.340 [0.4] | −0.200 [0.7] | 0.700 [0.04] * | 0.711 [0.02] * | 0.644 [0.06] | 0.870 [0.003] * | 0.050 [0.9] | 0.633 [0.06] | 0.400 [0.3] | 0.300 [0.6] | 0.630 [0.02] * | 0.610 [0.03] | n.a. | n.a. | 0.742 [0.005] * | 0.884 [0.0001] * | n.a. | n.a. | 0.650 [0.1] * | 1 |
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Al-Asmari, A.I.; Alharbi, H.; Zughaibi, T.A. Post-Mortem Analysis of Heroin Biomarkers, Morphine and Codeine in Stomach Wall Tissue in Heroin-Related Deaths. Toxics 2022, 10, 473. https://doi.org/10.3390/toxics10080473
Al-Asmari AI, Alharbi H, Zughaibi TA. Post-Mortem Analysis of Heroin Biomarkers, Morphine and Codeine in Stomach Wall Tissue in Heroin-Related Deaths. Toxics. 2022; 10(8):473. https://doi.org/10.3390/toxics10080473
Chicago/Turabian StyleAl-Asmari, Ahmed I., Hassan Alharbi, and Torki A. Zughaibi. 2022. "Post-Mortem Analysis of Heroin Biomarkers, Morphine and Codeine in Stomach Wall Tissue in Heroin-Related Deaths" Toxics 10, no. 8: 473. https://doi.org/10.3390/toxics10080473
APA StyleAl-Asmari, A. I., Alharbi, H., & Zughaibi, T. A. (2022). Post-Mortem Analysis of Heroin Biomarkers, Morphine and Codeine in Stomach Wall Tissue in Heroin-Related Deaths. Toxics, 10(8), 473. https://doi.org/10.3390/toxics10080473