Hair testing in postmortem diagnosis of substance abuse: An unusual case of slow-release oral morphine abuse in an adolescent.
Morphine sulfate misuse is essentially observed among regular heroin injectors. To our knowledge, primary addiction to morphine sulfate is exceptional, especially among young adolescents. A 13-year-old girl, with no history of addiction, was found dead with three empty blisters of Skenan(®) LP 30 mg at her side. Opiates were detected in biological fluids and hair by chromatographic methods. Blood analyses confirmed morphine overdose (free morphine: 428 ng/mL; total morphine: 584 ng/mL) and segmental hair analysis confirmed regular exposure over several months (maximum morphine concentration 250 pg/mg). Suspecting the victim's mother of recreational use of Skenan(®), the magistrate ordered analysis of her hair, with negative results. From an epidemiological viewpoint, this case of oral morphine sulfate abuse in an adolescent with no previous history suggests the emergence of a new trend of morphine sulfate consumption. From a toxicological viewpoint, it demonstrates the value of hair testing, which documented the victim's regular exposure and made an important contribution to the police investigation.
AP-HM, Hôpital de la Timone, Institut de Médecine Légale, 13385 Marseille, France. Electronic address: valerie.baillif-couniou@ap-hm.fr.
Valérie
V
Baillif-Couniou
X-Pertise Consulting, 67205 Oberhausbergen, France.
Pascal
P
Kintz
AP-HM, Hôpital de la Timone, Institut de Médecine Légale, 13385 Marseille, France.
Caroline
C
Sastre
INPS, Laboratoire de Police Scientifique, 13245 Marseille, France.
Phak-Rop Pos
PR
Pok
Laboratoire TOXLAB, 75018 Paris, France.
Marjorie
M
Chèze
Laboratoire TOXLAB, 75018 Paris, France.
Gilbert
G
Pépin
AP-HM, Hôpital de la Timone, Institut de Médecine Légale, 13385 Marseille, France; Aix-Marseille Université, 13284 Marseille, France.
Georges
G
Leonetti
AP-HM, Hôpital de la Timone, Institut de Médecine Légale, 13385 Marseille, France; Aix-Marseille Université, 13284 Marseille, France.
Anne-Laure
AL
Pelissier-Alicot
D000284:Administration, Oral; D000293:Adolescent; D003692:Delayed-Action Preparations; D062787:Drug Overdose; D005260:Female; D053593:Forensic Toxicology; D006197:Hair / Q000737:chemistry*; D006801:Humans; D009020:Morphine / Q000032:analysis* / Q000506:poisoning*; D009021:Morphine Dependence / Q000175:diagnosis*; D009294:Narcotics / Q000032:analysis* / Q000506:poisoning*; D015813:Substance Abuse Detection
D003692:Delayed-Action Preparations; D009294:Narcotics; D009020:Morphine
Addictions; Adolescent; Hair analysis; Overdose; Slow-release oral morphine