HELP understanding the (free)morphine levels in my Fiance's post mortum tox report

[noddingPixi]

First I'd like to explain that I am well aware that most people here are not Doctors, Coroners of Medical examiners. I'm asking these questions in hope of corresponding with people who have knowledge on the matter or who have gone through a similiar experience. Both the Corornor and the Medical Examiner have been of little or no help!


I'm having a difficult time finding out about the levels of substances that were in his blood. Ok. Here are some facts that I know are important in order to fully understand the situation. He was dead for about 6 hours before someone decided to make the phone call to the authorities, but that's a whole separate matter.

1. He died about 6am Sept. 5th and was found and pronounced dead at 12:42pm.
2. The Autopsy was performed Sept. 6th at 8:30 am.

He had been clean off of heroin for 3 years and apparently relapsed a few days before he died. He sniffed and did not inject unless someone could administer it for him which IS in fact what happened the night he died.

I want to know if the level of (free Morphine) was in an extremely lethal range.
The variance of (free) morphine levels in the tox reports of deadly Overdose victims that I DID find online have confused me due to the extreme differences in numbers.

Here are the numbers;
(Free)morphine: 220ng/ml
6MAM: <0.5ng/ml
Codeine(free):<25

He was 42 years old, 170 lbs and 5'11 inches tall. He was in perfect health. Heart, lungs, kidneys, liver were all remarkably healthy. Please can someone shed light on these levels. All of his blood samples were measured from Femoral blood.

I forgot to mention that there was a fair amount of Levamisole also found in his blood. I know Levamisole is used as a cut in the drugs, but it's more commonly found in cocaine. From what I understand Levamisole is pretty dangerous and can severly effect a persons immune system (white blood cells). It is banned in the U.S. and is only used by vets for deworming animals. Please help!!!!

Could the levels in his blood at all give an indication as to how much he used in that shot? I understand it's hard to tell given purity and what not, but could one conclude, given the level of free morphine in his blood, that he could have possibly commited suicide? The manner of death was left undetermined which in the long run may either make or break the wrongful death/ criminally negligent homicide case we are pursuing against the person who watched him die. Any help shedding some light on this would be such a blessing!! I know it's a tough question, so I welcome your opinions.

 

[needanswersnow]

I sure wish I had an answer for you. I am kinda in the same boat. I have results but no way to really know how much it was. he was dead for 4.5 days before I found him and it was another 18 hours before the blood was collected for tox. He had 6.4 mg/l in his heart blood and 22 mg/l in his spleen. His cause of death was meth toxicity... mine either smoked or snorted.... I hope you find the answers you are looking for. You can always call the medical examiner and ask them. I think that's what I am going to do.

 

[sekio]

Levels of morphine seen in femoral blood in post mortem overdose cases range from approx. 50 to approx. 500 ng/mL. The problem you'll run into is that levels of morphine/heroin in the blood that could be lethal to one individual, could be a tolerable "typical" blood concentration of someone who is a daily heavy opiate user.

Typical analgesic doses of morphine in peripheral blood is between 10 and 80 ng/mL, with ~20ng/ml being a common target blood level for pain control.

He had been clean off of heroin for 3 years and apparently relapsed a few days before he died.

In that case, chances are it's an accidental overdose, it's actually really common for someone "returning" to opioid usage after a long break to underestimate their tolerance. Especially if injection is involved.

Besides, if there is no outward indication that he was suicidal or dealing with depression it would seem somewhat unlikely for him to just decide to commit suicide one day. Especially if he was doing so in the presence of someone else!

I'm sorry for your loss. Hope this brings you some closure.

 

[Mad Dash]

Levels of morphine seen in femoral blood in post mortem overdose cases range from approx. 50 to approx. 500 ng/mL. The problem you'll run into is that levels of morphine/heroin in the blood that could be lethal to one individual, could be a tolerable "typical" blood concentration of someone who is a daily heavy opiate user.

Typical analgesic doses of morphine in peripheral blood is between 10 and 80 ng/mL, with ~20ng/ml being a common target blood level for pain control.



In that case, chances are it's an accidental overdose, it's actually really common for someone "returning" to opioid usage after a long break to underestimate their tolerance. Especially if injection is involved.

Besides, if there is no outward indication that he was suicidal or dealing with depression it would seem somewhat unlikely for him to just decide to commit suicide one day. Especially if he was doing so in the presence of someone else!

I'm sorry for your loss. Hope this brings you some closure.

Bold for emphasis

I have seen it happen numerous times. People get out of a state run inpatient facility against their will for like 6 months, get out and two days later OD on a relatively low dose of H. I am so sorry for your lose... I hope Seiko's information helped give you a little bit of closure from this. But at the end of the day it is far better to remember how they lived than how they died. God bless and I hope things get better for you.

I would like to point out this is why we practice harm reduction here. So for everyone taking hero doses and thinking there are not consequences to that behavior... well... we see it every day. Don't be a statistic...