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Postmortem toxicology can utilize alternative matrices like pericardial fluid, muscle, and vitreous humor when blood is unavailable. Opioid detection in these samples is possible, but quantitative interpretation requires caution.

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Area of Science:

  • Forensic Toxicology
  • Postmortem Analysis
  • Pharmacology

Background:

  • Peripheral blood is the preferred matrix for postmortem toxicological interpretation.
  • Alternative matrices are needed when blood sampling is not feasible due to decomposition or trauma.
  • Limited data exists on postmortem opioid concentrations in non-blood matrices.

Purpose of the Study:

  • To investigate the detection and comparability of methadone, buprenorphine, oxycodone, fentanyl, and tramadol concentrations in postmortem pericardial fluid, skeletal muscle, and vitreous humor compared to peripheral blood.
  • To assess the utility of these alternative matrices for toxicological interpretation.

Main Methods:

  • Analysis of methadone, buprenorphine, oxycodone, fentanyl, and tramadol in peripheral blood, cardiac blood, pericardial fluid, skeletal muscle, and vitreous humor from 54 autopsy cases.
  • Comparison of drug concentrations across different matrices.

Main Results:

  • Methadone, oxycodone, fentanyl, and tramadol were frequently detected in all alternative matrices.
  • Buprenorphine detection was less common.
  • Methadone concentrations in alternative matrices (except vitreous humor) were comparable to peripheral blood.
  • Significant concentration variations were observed for buprenorphine, oxycodone, and tramadol.
  • Quantitative analysis of fentanyl showed promise but was limited by small sample size.

Conclusions:

  • Alternative postmortem matrices (pericardial fluid, muscle, vitreous humor) are useful for detecting opioids when blood is unavailable.
  • Quantitative interpretation of opioid concentrations in these alternative matrices should be approached with caution due to potential variations.