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                            Library & Multimedia
 Parent and Metabolite Opioid Drug Concentrations in Unintentional Deaths Involving Opioid and Benzodiazepine Combinations
NCJ Number
              249393
Journal

*Journal of Forensic Sciences* Volume: 60 Issue: 4 Dated: July 2015 Pages: 950-956
Author(s)
          Marcia D. Fields;
                        Marie A. Abate B.S.;
                        Lan  Hu B.S.N;
                        D. Leann Long Ph.D.;
                        Matthew L. Blommel;
                        Nabila A. Haikal M.D.;
                        James C. Kraner Ph.D.
Date Published

July 2015
Length
              7 pages
Annotation
              This research project determined the effects of benzodiazepines on postmortem opioid parent and parent/metabolite blood concentration ratios for fentanyl-, hydrocodone-, methadone-, or oxycodone-related accidental deaths.
Abstract
              These opioids are partially metabolized by the CYP3A4 enzyme system, which is also affected by diazepam and alprazolam. Opioid/metabolite combinations examined in this study were as follows: fentanyl/norfentanyl, hydrocodone/dihydrocodeine, methadone/EDDP, and oxycodone/oxymorphone. Parent opioid concentrations were analyzed for 877 deaths. Parent/metabolite concentration ratios were analyzed for 349 deaths, excluding cases with co-intoxicants present known to interfere with opioid elimination. Alprazolam in combination with diazepam significantly decreased median hydrocodone concentrations by 48 percent (p = 0.01) compared to hydrocodone alone. The methadone parent/metabolite concentration ratio was reduced by 35 percent in the presence of diazepam compared to methadone alone (p = 0.03). Benzodiazepines did not statistically significantly affect fentanyl or oxycodone concentrations. Possible factors affecting opioid concentrations and possible toxicity development, including any differential effects on specific opioids, should continue to be explored.  (Publisher abstract modified)
      
  
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        NIJ-Sponsored


  
  
        
  Publication Type
        Research (Applied/Empirical)
                                Report (Study/Research)
                                Report (Grant Sponsored)
    
  
  
Date Published: July 1, 2015
    
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