Driving under the influence of opiates: Concentration relationships between morphine, codeine, 6-acetyl morphine, and ethyl morphine in blood
Driving under the influence of opiates: Concentration relationships between morphine, codeine, 6-acetyl morphine, and ethyl morphine in blood
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DOI：
10.1093/jat/32.4.265
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发表时间：
2008-05-01
影响因子：
2.5
通讯作者：
Kugelberg, Fredrik C.
中科院分区：
文献类型：
--
作者：
Jones, A. Wayne;Holmgren, Anita;Kugelberg, Fredrik C.
吗啡和可待因经常在受损司机的血液样本中被发现。但是这些鸦片制剂是否反映了处方止痛药的使用或非法药物海洛因（二乙酰吗啡）的滥用并不总是显而易见的。阿片类药物，无论是单独或与其他药物一起，确定在2573血液标本受损的司机敏感和具体的分析方法。海洛因6-乙酰吗啡（6-AM）的特定代谢物在平均值、中位数和最高浓度分别为0.015、0.010和0.10 mg/L时仅52例（2%）可定量。吗啡的平均、中位和最高浓度分别为0.046、0.03和1.13 mg/L（N= 2029）。可待因（N= 1391）的相应浓度为0.047、0.01和2.40 mg/L。在63例病例中发现乙基吗啡，平均浓度为0.055 mg/L（中位数为0.03 mg/L）。当6-AM存在于尿液中时（N= 324），血液中的平均吗啡/可待因比值为7.5（中位数6.7），只有两例病例中这一重要比值小于1。这项研究发现了令人信服的证据，即在瑞典，90%的血液中含有吗啡和可待因的被捕司机使用过海洛因。
Morphine and codeine are frequently identified in blood samples from impaired drivers. But whether these opiates reflect the use of prescription analgesics or abuse of the illicit drug heroin (diacetyl morphine) is not always obvious. Opiates, either alone or together with other drugs, were determined in 2573 blood specimens from impaired drivers by sensitive and specific methods of analysis. The specific metabolite of heroin 6-acetyl morphine (6-AM) was quantifiable in only 52 cases (2%) at mean, median, and highest concentrations of 0.015, 0.010, and 0.10 mg/L, respectively. The mean, median, and highest concentrations of morphine were 0.046, 0.03, and 1.13 mg/L, respectively (N= 2029). The corresponding concentrations of codeine (N= 1391) were 0.047, 0.01, and 2.40 mg/L. Ethyl morphine was identified in 63 cases at a mean concentration of 0.055 mg/L (median 0.03 mg/L). When 6-AM was present in urine (N= 324), the mean morphine/codeine ratio in blood was 7.5 (median 6.7), and this important ratio was less than unity in only two cases. This study finds compelling evidence that ∼90% of apprehended drivers in Sweden with morphine and codeine in their blood had used heroin.