SOFT 2004 Meeting Abstracts - Society of Forensic Toxicologists

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M12
OPIATE CONCENTRATIONS IN HAIR FROM SUBJECTS IN A CONTROLLED HEROIN­
MAINTENANCE PROGRAM AND FROM OPIATE-ASSOCIATED FATALITIES
MusshoffF*, Lachenmeier K., Wollersen H., Madea B.: Institut ofLegaJ Medicine, Bonn, Germany
Introduction: The objective of this study was the determination of the concentration of opiates (heroin =
HER, mono acetyl morphine MAM, morphine = MOR, codeine COD, acetyl codeine AC) in hair,
and in particular an investigation of dose-concentration relationships as well as the possibility of using AC
as a marker for consumption of illicit heroin in contrast to pharmaceutical heroin.
Methodology: After the controlled Lv. administration of pharmaceutical heroin-HCI (l0-1000 mg/d), the
concentrations of opiates in head hair were determined (n = 46), using a validated GC-MS method with
LOD's between 0.02 and 0.04 ng/mg. In addition, a collective of opiate-associated fatalities was examined
(n 24).
Results: The concentrations obtained in the proximal segment (1 cm) of the patients were between 0.04
and 0.21 ng/mg for HER, for MAM betv.een 0.05 and 5.64 ng/mg and for MOR between 0.03 and 8.37
ng/mg. There was no statistically significant difference in the concentrations in comparison to the opiate
fatalities (HER 1.55-5.20 ng/mg, MAM 0.04-30.01 ng/mg, MOR 0.03-11.87 ng/mg in the proximal
segments). After controlled heroin administration, a correlation between the dose and the total opiate
concentration in the hair was found (r=0.66). When considering a single analyte, the coefficient of
correlation increased when plasma half-life increases (r=OA2, r=0.58 and r=O.69 for HER, MAM and
MOR). COD and AC were detected in 13.0 % and 10.9 % of the samples of the heroin program, as well as
in 33.3 % and 16.7 % in opiate-associated fatalities, respectively.
Discussion: The results confirm the first observations of Kintz et aI., who found only limited doseconcentration
relationships after HER abuse in hair. The correlation is influenced by the plasma half-lifes
of analytes. The lack of differences between obtained opiate concentrations in the hair of participants in a
controlled heroin maintenance program and of opiate-associated fatalities does not support the hypothesis
that a lack of tolerance can be regarded as a potential cause of death. In addition, the absence of AC also in
the majority ofthe deaths questions its suitability as a characteristic marker of a preceding consumption of
illicit heroin.
Keywords: Hair analysis, opiates, heroin maintenance program
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