The relationship between ante-mortem and post-mortem morphine concentrations

Context of the Article: An important forensic problem is whether the presence of a drug such as morphine caused or contributed to a death or was merely incidental. The reliance that can be based on postmortem drug concentrations remains controversial. To investigate this further we obtained antemortem and postmortem samples of individuals admitted to hospital who were receiving morphine and who died in hospital. Methods: Eleven subjects were recruited. Samples were sent for analysis for free and total morphine concentrations. Results: The median difference (postmortem–antemortem) free morphine concentration was 25.5 (range 0 to +126) µg/L, p <.01; the mean difference between postmortem and antemortem total morphine concentration was 34.5 (range −225 to 342) µg/L (not significant). Discussion: Our study supports previous investigators who note that there is an inconstant and sometimes tenuous relationship between ante- and postmortem morphine concentrations.