Hair morphine concentrations of fatal heroin overdose cases and living heroin users.
OBJECTIVE
To compare heroin and other opiate use of heroin overdose fatalities, current street heroin users and drug-free therapeutic community clients.


METHODS
Hair morphine concentrations that assess heroin use and other opiate use in the 2 months preceding interview or death were compared between heroin overdose fatalities diagnosed by forensic pathologists (FOD) (n = 42), current street heroin users (CU) (n = 100) and presumably abstinent heroin users in a drug-free therapeutic community (TC) (n = 50).


METHODS
Sydney, Australia.


RESULTS
The mean age and gender breakdown of the three samples were 32.3 years, 83% male (FOD), 28.7 years, 58% male (CU) and 28.6 years, 60% male (TC). The median blood morphine concentration among the FOD cases was 0.35 mg/l, and 82% also had other drugs detected. There were large differences between the three groups in hair morphine concentrations, with the CU group (2.10 ng/mg) having concentration approximately four times that of the FOD group (0.53 ng/mg), which in turn had a concentration approximately six times that of the TC group (0.09 ng/mg). There were no significant differences between males and females in hair concentrations within any of the groups. Hair morphine concentrations were correlated significantly with blood morphine concentrations among FOD cases (r = 0.54), and self-reported heroin use among living participants (r = 0.57).


CONCLUSIONS
The results indicate that fatal cases had a lower degree of chronic opiate intake than the active street users, but they were not abstinent during this period.
Darke
Shane
S
National Drug and Alcohol Research Centre, University of New South Wales, Austrlia. s.darke@unsw.edu
Hall
Wayne
W
Kaye
Sharlene
S
Ross
Joanne
J
Duflou
Johan
J
D000293:Adolescent; D000328:Adult; D001344:Autopsy; D062787:Drug Overdose; D005260:Female; D006197:Hair / Q000737:chemistry*; D003932:Heroin / Q000506:poisoning*; D006556:Heroin Dependence / Q000175:diagnosis*; D006801:Humans; D008297:Male; D009020:Morphine / Q000032:analysis*; D009294:Narcotics / Q000506:poisoning*; D009517:New South Wales
D009294:Narcotics; D003932:Heroin; D009020:Morphine