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Published on: April 23, 2019
Bile analysis in heroin overdose
Giovanna Tassoni1, Claudio Cacaci, Massimiliano Zampi
1Institute of Legal Medicine, University of Macerata, via Don Minzoni 9, I-62100 Macerata, Italy.
Journal of Forensic Sciences
|October 20, 2007
Summary
Morphine can be stored in the gallbladder, as shown by its presence in bile and hair of an addict 144 hours after the last dose. The enterohepatic cycle (EHC) likely plays no role in morphine reabsorption after this time.
Area of Science:
- Pharmacology
- Toxicology
- Gastroenterology
Background:
- Morphine metabolism and elimination involve the liver and bile.
- The enterohepatic cycle (EHC) can lead to the reabsorption of substances from the bile back into circulation.
- Understanding morphine's fate in the body is crucial for addiction treatment and forensic analysis.
Observation:
- A case study of an opioid addict who survived for 144 hours (6 days) after their last morphine injection.
- Morphine was detected in bile (21.3 mug/mL) and hair (4.8 ng/mg).
- Morphine was notably absent in blood, urine, and liver samples.
Findings:
- The enterohepatic cycle (EHC) appears to have minimal to no role in morphine reabsorption approximately 144 hours after the last dose.
- The gallbladder functions as a significant storage depot for morphine.
- Morphine levels in bile may correlate with chronic opiate use.
Implications:
- This case provides direct evidence for the gallbladder acting as a morphine reservoir.
- The findings suggest that the EHC's contribution to morphine bioavailability diminishes significantly over time post-administration.
- This research could inform strategies for managing opioid addiction and interpreting forensic toxicology results.
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