Zughaibi Torki A, Assiri Ziad, Mirza Ahmed, Alharbi Hassan, Alzahrani Abdulnasser E, Alahmadi Sultan A, Alsolami Faiz, Al-Saadi Adel, Almoustady Mohamed, Al-Zahrani Sultan, Altowairqi Majda, Al-Asmari Ahmed I
Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
Toxics. 2025 Mar 20;13(3):229. doi: 10.3390/toxics13030229.
This study assessed and compared the postmortem concentrations of 6-monoacetylmorphine [6-MAM] and 6-acetylcodeine [6-AC], morphine, and codeine in various tissues and fluids from 52 postmortem cases related to heroin use. Samples were received at the Poison Control and Forensic Chemistry Center in Jeddah, Saudi Arabia, and analyzed using liquid chromatography-mass spectrometry. Descriptive and inferential statistics, including median, range, variability, and outliers, were used for analysis. The results showed significant variability in heroin and metabolite concentrations across different fluids and tissues. Tissue specimens were analyzed in 38 cases (73%), with 50% of cases exhibiting putrefaction. Blood and tissue samples were available in 39 cases, highlighting the need for alternative specimens in challenging cases. Notably, heroin metabolites were detected in unique matrices, such as nasal swabs, bladder tissues, lung tissues, and small intestine tissues, underscoring the potential of these samples in forensic investigations, especially when traditional bodily fluids are unavailable or compromised. These findings suggest that environmental factors, timing of substance use, and postmortem changes influence substance distribution, emphasizing the need to consider the location of death when interpreting toxicological results for accurate forensic analysis. This study provides valuable insights into the distribution, correlation, and significance of heroin and its metabolites in postmortem samples, aiding the confirmation of heroin overdose. These findings contribute to the limited data on postmortem cases in the Middle East and North Africa, particularly Saudi Arabia, supporting efforts to curb drug abuse in this region. This knowledge can inform public health strategies and forensic practices, ultimately aiding efforts to address and mitigate drug abuse.
本研究评估并比较了52例与海洛因使用相关的死后案例中，各种组织和体液中6-单乙酰吗啡[6-MAM]、6-乙酰可待因[6-AC]、吗啡和可待因的死后浓度。样本由沙特阿拉伯吉达的毒物控制和法医化学中心接收，并采用液相色谱-质谱法进行分析。分析使用了描述性和推断性统计方法，包括中位数、范围、变异性和异常值。结果显示，不同体液和组织中的海洛因及其代谢物浓度存在显著差异。38例（73%）进行了组织标本分析，其中50%的案例出现了腐败现象。39例有血液和组织样本，这凸显了在具有挑战性的案例中需要替代标本。值得注意的是，在独特的基质中检测到了海洛因代谢物，如鼻拭子、膀胱组织、肺组织和小肠组织，这突出了这些样本在法医调查中的潜力，特别是在传统体液不可用或受到影响的情况下。这些发现表明，环境因素、物质使用时间和死后变化会影响物质分布，强调在解释毒理学结果以进行准确法医分析时需要考虑死亡地点。本研究为海洛因及其代谢物在死后样本中的分布、相关性和意义提供了有价值的见解,有助于确认海洛因过量。这些发现为中东和北非，特别是沙特阿拉伯的死后案例提供了有限的数据，支持了该地区遏制药物滥用的努力。这些知识可为公共卫生策略和法医实践提供参考，最终有助于应对和减轻药物滥用问题。
