Bogusz M.J., Maier R.D., Driessen S.

Institute of Forensic Medicine, Aachen University of Technology, D-52057 Aachen, Germany

Morphine (Mo), morphine-3-glucuronide (M-3-G), morphine-6-glucuronide (M-6-G) and 6-monoacetylmorphine (6-MAM) were isolated from body fluids using solid phase extraction and determined by means of atmospheric pressure chemical ionization mass spectrometry - liquid chromatography (APCI-LC-MS) in selected ion monitoring mode. The following ions were monitored: m/z 286 for Mo, m/z 286 and 462 for M-3-G and M-6-G, m/z 211, 268 and 328 for 6-MAM and m/z 289 for morphine-D3 (internal standard). The recoveries ranged from 82% to 89%, the limits of detection were: 0.1 ng/ml (Mo), 0.5 ng/ml (6-MAM), 1 ng/ml (M-3-G and M-6-G).
The analytes were determined in samples taken from 21 heroin overdose victims. 21 blood samples, 11 cerebrospinal fluid (CSF) samples, 12 vitreous humor (VH) samples and 6 urine samples were investigated. Blood concentrations (ng/ml) of Mo ranged from 8 to 1539, of M-3-G from 111 to 941, of M-6-G from 32 to 332, of 6-MAM from 0 to 73. The levels of Mo were correlated with glucuronide values and with 6-MAM (Mo/M-3-G r=0.5305; Mo/M-6-G r=0.3253; Mo/6-MAM r=0.8739). The concentrations of Mo, M-3-G and M-6-G in CSF were, as a rule, lower than in blood, and in VH lower than in CSF. The concentrations of Mo and molar ratios M-6-G/Mo in blood and CSF were correlated (Mo/M-6-G in blood to Mo/M-6-G in CSF r=0.9919). Molar ratios M3G/Mo and M6G/Mo lower than 2 in blood of heroin overdose victims together with high 6-MAM indicated short survival time after drug intake.