title: Comparative toxicology of fatal heroin overdose cases and morphine positive homicide victims.
abstract: OBJECTIVE
  To compare the blood toxicology of heroin overdose cases and morphine positive homicide victims.
  
  
  METHODS
  Analysis of coronial cases.
  
  
  METHODS
  Sydney, Australia. Cases A total of 705 cases of death due to opioid toxicity and 28 morphine positive homicide cases (1 January 1998-31 December 2002).
  
  
  RESULTS
  There was no significant difference between the median morphine concentrations of the overdose and homicide groups (0.50 versus 0.45 mg/l). The overdose group was more likely to have blood alcohol (OR 3.21) present, but less likely to have methadone (OR 0.26) and cannabis (OR 0.04). There was a significant negative correlation between blood morphine and alcohol concentrations among the overdose group (rho = -0.32), but not among the homicide group (rho = -0.03). Independent predictors of a higher blood morphine concentration were a lower alcohol concentration and a higher methadone concentration.
  
  
  CONCLUSIONS
  Morphine concentrations per se are not diagnostic of overdose. The study confirms the salience of concomitant alcohol consumption in such events.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, NSW, Australia. s.darke@unsw.edu.au
authors.forename: Shane
authors.initials: S
authors.lastname: Darke
authors.forename: Johan
authors.initials: J
authors.lastname: Duflou
authors.forename: Sharlene
authors.initials: S
authors.lastname: Kaye
mesh_terms: D000328:Adult; D002423:Cause of Death; D062787:Drug Overdose / Q000097:blood / Q000150:complications / Q000453:epidemiology; D005260:Female; D005554:Forensic Medicine / Q000379:methods; D003932:Heroin / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning*; D006556:Heroin Dependence / Q000097:blood / Q000401:mortality*; D006708:Homicide / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning; D009517:New South Wales / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000097:blood / Q000150:complications / Q000401:mortality*