Related Experiment Videos
Driving and intrathecal morphine administration
G Van den Bosch1, M De Doncker, P Vercruysse
1Laboratory of Medical Biochemistry and Toxicology, Algemeen Centrumziekenhuis Antwerpen, Campus Stuivenberg, Lange Beeldekensstraat 267, Antwerp, 2020, Belgium.
European Journal of Pain (London, England)
|December 18, 2001
Summary
Belgian law limits morphine levels for drivers. Patients on intrathecal morphine (continuous morphine delivered into the spinal fluid) did not exceed blood limits but had high urine concentrations, posing a risk for roadside drug tests.
Area of Science:
- Pharmacology and Toxicology
- Clinical Chemistry
- Forensic Science
Background:
- Recent Belgian legislation established maximum permissible morphine concentrations in blood and urine for individuals operating vehicles.
- This has raised concerns regarding the implications for patients undergoing medical treatments involving opiates, specifically continuous intrathecal morphine administration.
Purpose of the Study:
- To determine morphine concentrations in the blood and urine of patients receiving continuous intrathecal morphine.
- To evaluate the impact of water intake on these concentrations and correlate them with the daily intrathecal morphine dosage.
- To assess the potential for these patients to exceed legal driving limits for morphine.
Main Methods:
- Gas chromatography-mass spectrometry (GC-MS) was employed to quantify morphine levels.
- Measurements were taken in whole blood and urine samples from 15 patients on continuous intrathecal morphine.
- The study also assessed variations in concentrations following water intake and their relationship to prescribed daily doses.
Main Results:
- All patients consistently remained below the legal blood morphine limit of 20 ng/ml, even those on high-dose regimens.
- Conversely, urine morphine concentrations frequently surpassed the legal limit of 300 ng/ml by significant margins.
- Water intake showed some effect on concentrations, and a correlation with the daily intrathecal morphine dose was observed.
Conclusions:
- Patients on continuous intrathecal morphine therapy are unlikely to exceed legal blood morphine limits while driving.
- However, elevated urine morphine levels present a risk of positive roadside drug tests, potentially leading to legal complications.
- Awareness of these findings is crucial for patients on intrathecal opiates to avoid unintended legal consequences.