title: Death in a legal poppy field in Spain.
abstract: Opium is a substance extracted from Papaver somniferum L. Opium latex contains morphine, codeine, and thebaine and non-analgesic alkaloids such as papaverine and noscapine. In Spain opium growing is allowed only for scientific or pharmaceutical purposes and harvest is supervised by the Spanish Health Ministry. This work describes a sudden fatality involving opium consumption in a legal poppy field. The toxicological and autopsy findings, previous disease, paraphernalia, and scenario are discussed in order to clarify cause and manner of death. A 32-year-old white caucasian male was found unresponsive in a legal poppy field in the South of Spain. The emergency medical services responded to the scene where he was pronounced dead. The friends explained that the deceased had presented with about 30min of convulsions; in spite of trying to keep his airway tract open they noted that "he stayed airless". According to them the victim suffered from epilepsy. Tools found beside his body consisted of plain wood sticks with a blade razor, a fabric handle, and paper. A comprehensive toxicological screening for abuse and psychoactive drugs was performed in the deceased samples. This included ethanol and volatile analysis by HS-GC-FID in peripheral blood and urine, enzyme immunoassay in urine by CEDIA, and a basic drug screening in all samples (including paraphernalia) by GC-MS using modes full scan for screening/confirmation and selected ion monitoring for quantitation. The peripheral blood, urine, vitreous, and gastric content contained the following concentrations of opiates expressed in mg/L (gastric content additionally also expressed in mg total): 0.10, 7.12, 0.23, and 14.80 (2.81mg total) of thebaine, 0.13, 4.50, 0.13, and 6.60 (1.25mg total) of morphine (free), 0.48, 0.88, 0.17, and 1.50 (0.28mg total) of codeine. These tree opiates were also detected in the tools (paraphernalia) used by the deceased for opium consumption. Other toxicological findings were metabolites of cocaine and cannabis. Apparently the victim stole poppy capsules and ingested an unknown quantity of the latex with the goal to obtain euphoric effects. The cause of death was considered poly-drug toxicity with a preponderant role of thebaine and morphine. In addition, the epileptic condition of the deceased could have played a role. As far as we know, there are no previous reports of fatalities occurring in legal poppy fields.
authors: National Institute of Toxicology and F. Sciences, Ministry of Justice, C/ José Echegaray 4, 28032 Las Rozas de Madrid, Madrid, Spain. Electronic address: mariaantonia.martinez@justicia.es.
authors: María Antonia
authors: MA
authors: Martínez
authors: National Institute of Toxicology and F. Sciences, Ministry of Justice, C/ José Echegaray 4, 28032 Las Rozas de Madrid, Madrid, Spain. Electronic address: salome.ballesteros@justicia.es.
authors: Salomé
authors: S
authors: Ballesteros
authors: National Institute of Toxicology and F. Sciences, Ministry of Justice, C/ José Echegaray 4, 28032 Las Rozas de Madrid, Madrid, Spain. Electronic address: elena.almarza@justicia.es.
authors: Elena
authors: E
authors: Almarza
authors: Medico-Legal Institute of Albacete, C/ San Agustín 1, 02001-Albacete, Spain. Electronic address: joaquin.garijo@justicia.es.
authors: Joaquín
authors: J
authors: Garijo
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004827:Epilepsy / Q000150:complications; D017809:Fatal Outcome; D049429:Forensic Pathology; D006801:Humans; D008297:Male; D009892:Opium / Q000506:poisoning*; D010207:Papaver; D011041:Poisoning / Q000175:diagnosis; D013030:Spain
chemical_list: D009892:Opium
keywords: Fatality; Opium; Poisoning; Poppy Fields