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Published on: April 23, 2019
Prevalence of dihydrocodeine in hydrocodone positive postmortem specimens
Amanda J Jenkins1, Eric S Lavins, Courtney Hunek
1Lake County Crime Laboratory, 235 Fairgrounds Road, Painesville, OH 44077, USA. amanda.jenkins@umassmemorial.org
Journal of Forensic and Legal Medicine
|January 13, 2009
Summary
Dihydrocodeine (DHC) was detected in 47% of hydrocodone (HC) positive deaths. This study evaluated DHC prevalence and concentrations to assess its role in opioid-related fatalities.
Area of Science:
- Forensic Toxicology
- Analytical Chemistry
- Pharmacology
Background:
- Opioid-related deaths in the US are increasing, with a focus on psychotherapeutic drugs.
- The role of dihydrocodeine (DHC) in hydrocodone (HC)-related fatalities is largely unknown due to limited testing.
Purpose of the Study:
- To determine the prevalence of DHC in decedents who tested positive for HC.
- To report DHC concentrations in these cases.
- To evaluate DHC's potential contribution to mortality and its inclusion in opioid testing protocols.
Main Methods:
- Specimens were analyzed using liquid-liquid or solid phase extraction followed by gas chromatography/mass spectrometry (GC/MS) in selected ion monitoring mode.
- A multipoint calibration curve was used for quantification within the 2-600 ng/mL linear range.
- Accuracy and precision were validated for HC, DHC, and hydromorphone (HM).
Main Results:
- Of 136 HC-positive cases, 64 (47%) also tested positive for DHC.
- Hydrocodone (HC) concentrations ranged from 9-3039 ng/mL in heart blood and 42-12353 ng/mL in urine.
- Dihydrocodeine (DHC) concentrations ranged from 3-243 ng/mL in heart blood and 5-1842 ng/mL in urine, with DHC/HC ratios exceeding 0.50 in 16% of blood and 24% of urine cases.
Conclusions:
- Dihydrocodeine (DHC) is frequently present in hydrocodone (HC) positive decedents.
- The detected concentrations and ratios suggest DHC may play a role in opioid-related deaths.
- Routine inclusion of DHC testing in opioid analysis protocols is warranted.
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