title: In vitro formation of acetylmorphine from morphine and aspirin in postmortem gastric contents and deionized water.
abstract: Forensic toxicologists consider detection of 6-acetylmorphine (6-AM) definitive evidence of heroin abuse. This study investigated the possibility that aspirin, when in solution with morphine, may acetylate morphine to produce acetylmorphine (AM). Morphine sulfate-extended release tablets (15 mg) and aspirin (325 mg) tablets were incubated in 50 mL postmortem gastric contents or deionized water at 37°C. One-milliliter aliquots were taken at timed intervals, extracted by solid-phase extraction, derivatized and analyzed by the gas chromatograph with a mass selective detector. Both 3- and 6-AM were detected in samples containing morphine and aspirin in combination; no heroin was detected. Production of AM was pH dependent with optimal formation at pH ≥4. In gastric contents, concentrations of 3-AM exceeded that of 6-AM by ∼10-fold. Production of 3-AM in gastric contents was approximately twice as high as it was in water, while matrix did not appear to affect 6-AM production. Urine specimens (10,602) assayed at a pain management laboratory and postmortem cases (>6,000) were investigated for in vivo formation of AM. Three cases exhibited unexplained 6-AM results. These data indicate that in vivo formation of 6-AM from the co-administration of aspirin and morphine, if it happens, is quite rare. In instances where this is suspected, 3-AM should be monitored.
authors: 1 Cuyahoga County Medical Examiner's Office, Cleveland, OH, USA.
authors: Claire K
authors: CK
authors: Naso-Kaspar
authors: John F
authors: JF
authors: Wyman
authors: C Randall
authors: CR
authors: Clark
authors: Leon R
authors: LR
authors: Glass
authors: Eric S
authors: ES
authors: Lavins
authors: Cassandra E
authors: CE
authors: Cushman
authors: Krista L
authors: KL
authors: Pekarski
authors: Thomas P
authors: TP
authors: Gilson
mesh_terms: D001241:Aspirin / Q000737:chemistry*; D053593:Forensic Toxicology / Q000379:methods*; D005766:Gastrointestinal Contents / Q000737:chemistry*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D057230:Limit of Detection; D009020:Morphine / Q000737:chemistry*; D009022:Morphine Derivatives / Q000032:analysis*; D011180:Postmortem Changes; D015813:Substance Abuse Detection / Q000379:methods*; D014867:Water / Q000737:chemistry
chemical_list: D009022:Morphine Derivatives; D014867:Water; C017542:O(3)-monoacetylmorphine; D009020:Morphine; C026979:6-O-monoacetylmorphine; D001241:Aspirin