Bile Analysis in Heroin Overdose

:  Following its metabolism in the liver, morphine and its metabolites can be directly eliminated in bile. Then, they undergo the enterohepatic cycle (EHC) and mostly reappear in the circulation. We report a case showing the presence of morphine in bile (21.3 μg/mL) and hair (4.8 ng/mg) but not in b...

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Bibliographic Details
Published in:Journal of forensic sciences 2007-11, Vol.52 (6), p.1405-1407
Main Authors: Tassoni, Giovanna, Cacaci, Claudio, Zampi, Massimiliano, Froldi, Rino
Format: Article
Language:English
Subjects:
Adult
Bile
Bile - chemistry
Biological Availability
Drug Overdose
enterohepatic circle
forensic science
Forensic sciences
Forensic Toxicology
Gallbladder
Gas Chromatography-Mass Spectrometry
Hair - chemistry
Heroin
Heroin - analysis
Heroin - poisoning
heroin death
Humans
Liver - chemistry
Male
Morphine - analysis
Morphine - pharmacokinetics
Narcotics
Narcotics - analysis
Narcotics - pharmacokinetics
Narcotics - poisoning
toxicology
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Summary::  Following its metabolism in the liver, morphine and its metabolites can be directly eliminated in bile. Then, they undergo the enterohepatic cycle (EHC) and mostly reappear in the circulation. We report a case showing the presence of morphine in bile (21.3 μg/mL) and hair (4.8 ng/mg) but not in blood, urine or the liver of an addict who survived in hospital for about 144 h (6 days). These data would indicate that the EHC does not play any role about 144 h after the last injection, and directly confirms that gall bladder is a storage depot for morphine. They constitute the first report of a demonstration of the effect of the EHC on morphine bioavailability in an addict, and could be considered as indication, without supporting circumstantial evidence, that the morphine level in bile is related to chronic opiate use.
ISSN:0022-1198
1556-4029
DOI:10.1111/j.1556-4029.2007.00563.x