The rapidity of overdose and death is of major clinical importance. Essentially, is there time to intervene, or are such deaths typically so rapid as to preclude meaningful intervention? The presence of 6-monoacetly-morphine (6MAM) is indicative of a rapid death following heroin administration. to estimate the proportions of rapid and delayed death amongst fatal heroin overdose cases. To date, no study has used 6MAM to estimate the proportions of rapid and delayed death amongst fatal heroin overdose cases.

Project Collaborators External

• Professor Johan DuflouSydney Medical School, University of Sydney

Project Supporters

Australian Government Department of Health and Ageing

The rapidity of overdose and death is of major clinical importance. Essentially, is there time to intervene, or are such deaths typically so rapid as to preclude meaningful intervention? The presence of 6-monoacetly-morphine (6MAM) is indicative of a rapid death following heroin administration. to estimate the proportions of rapid and delayed death amongst fatal heroin overdose cases. To date, no study has used 6MAM to estimate the proportions of rapid and delayed death amongst fatal heroin overdose cases.

The study aimed to:

1. Determine the proportions of fatal heroin overdose cases in which blood 6MAM was detected, as a proxy measure of rapid death;
2. Determine the toxicological correlates of 6MAM; and
3. Determine the circumstantial correlates of 6MAM.

Design and Method

Analysis of consecutive cases of heroin-related deathpresenting to the Department of Forensic Medicine Sydney, 1/1/2013-12/12/2014. Core toxicological data analysed were free morphine concentration, 6-monoacetyl morphine (6MAM), morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G).

Progress/Update

Data collection is complete.

Benefits

The study will provide novel data on survival times following heroin overdose.

A paper has been written and submitted for publication: Darke, S. & Duflou, J.The toxicology of heroin-related death: estimating survival times.