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Blood codeine concentrations in fatalities associated with codeine.

J A Wright, R C Baselt, C H Hine

    Clinical Toxicology
    |January 1, 1975
    PubMed
    Summary
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    This study examined eight deaths from codeine overdose, finding blood codeine levels between 1.4-5.6 mug/ml. Morphine presence suggested potential heroin use, not codeine metabolism.

    Area of Science:

    • Toxicology
    • Forensic Science
    • Pharmacology

    Background:

    • Codeine is an opioid analgesic with potential for overdose.
    • Accurate toxicological analysis is crucial in post-mortem investigations.

    Observation:

    • Eight cases of death primarily due to codeine overdosage were analyzed.
    • Blood codeine concentrations in overdose cases ranged from 1.4 to 5.6 mug/ml.
    • One case of violent death in a codeine user showed a blood codeine concentration of 2.6 mug/ml.

    Findings:

    • Gas-liquid chromatography confirmed codeine levels in blood samples.
    • Morphine was detected in two samples (0.2 and 0.6 mug/ml), possibly indicating concurrent heroin use.
    • The findings differentiate codeine toxicity from other opioid involvements.

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    Implications:

    • Establishes toxicological reference ranges for codeine in fatal cases.
    • Highlights the importance of differentiating codeine metabolism from heroin use in forensic toxicology.
    • Informs clinical and legal interpretations of codeine concentrations in overdose and other deaths.