Methadone, Buprenorphine, Oxycodone, Fentanyl and Tramadol in Multiple Postmortem Matrices.

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.