Jones A Wayne, Holmgren Anita, Kugelberg Fredrik C
Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Artillerigatan 12, SE-581 33 Linköping, Sweden.
J Anal Toxicol. 2008 May;32(4):265-72. doi: 10.1093/jat/32.4.265.
Morphine and codeine are frequently identified in blood samples from impaired drivers. But whether these opiates reflect the use of prescription analgesics or abuse of the illicit drug heroin (diacetyl morphine) is not always obvious. Opiates, either alone or together with other drugs, were determined in 2,573 blood specimens from impaired drivers by sensitive and specific methods of analysis. The specific metabolite of heroin 6-acetyl morphine (6-AM) was quantifiable in only 52 cases (2%) at mean, median, and highest concentrations of 0.015, 0.010, and 0.10 mg/L, respectively. The mean, median, and highest concentrations of morphine were 0.046, 0.03, and 1.13 mg/L, respectively (N = 2,029). The corresponding concentrations of codeine (N = 1,391) were 0.047, 0.01, and 2.40 mg/L. Ethyl morphine was identified in 63 cases at a mean concentration of 0.055 mg/L (median 0.03 mg/L). When 6-AM was present in urine (N = 324), the mean morphine/codeine ratio in blood was 7.5 (median 6.7), and this important ratio was less than unity in only two cases. This study finds compelling evidence that approximately 90% of apprehended drivers in Sweden with morphine and codeine in their blood had used heroin.
在受损驾驶员的血液样本中经常能检测出吗啡和可待因。但这些阿片类药物究竟是反映了处方镇痛药的使用情况，还是非法药物海洛因（二乙酰吗啡）的滥用情况，往往并不明确。采用灵敏且特异的分析方法，对2573份受损驾驶员的血液样本中的阿片类药物（单独或与其他药物一起）进行了测定。海洛因的特定代谢物6 - 乙酰吗啡（6 - AM），在仅52例样本（2%）中可定量，其平均浓度、中位数浓度和最高浓度分别为0.015、0.010和0.10毫克/升。吗啡的平均浓度、中位数浓度和最高浓度分别为0.046、0.03和1.13毫克/升（N = 2029）。可待因（N = 1391）的相应浓度分别为0.047、0.01和2.40毫克/升。在63例样本中鉴定出了乙基吗啡，平均浓度为0.055毫克/升（中位数为0.03毫克/升）。当尿液中存在6 - AM时（N = 324），血液中吗啡/可待因的平均比值为7.5（中位数为6.7），且只有两例该重要比值小于1。这项研究发现了令人信服的证据，表明在瑞典，约90%血液中含有吗啡和可待因的被捕驾驶员使用过海洛因。
