{"doi":"10.2298/sarh181005003j","title":"The importance of 6-MAM levels and morphine/codeine ratio in diagnosis of death among drug addicts","abstract":"<jats:p>Introduction/Objective. Heroin is metabolized to 6-monoacetylmorphine (6-MAM) and morphine. The objective of this study is to examine 6-MAM, morphine, and codeine relationships in order to distinguish deaths related to heroin consumption from deaths related to morphine and/or codeine consumption. Methods. The autopsy blood and urine samples from 45 opioid drug addicts were examined. Gas chromatography/mass spectrometry was applied to evaluate morphine, 6-MAM, and codeine. Two groups were formed: 6-MAM-positive (n = 35) and 6-MAM-negative (n = 10). Results. Compared to the 6-MAM-negative group, blood morphine levels were higher in the 6-MAMpositive group (p = 0.022), while blood codeine levels were similar (p = 0.575). In the 6-MAM-negative group, the blood morphine/codeine ratio was 8.3, and it was 4.3 in the 6-MAM-positive group. There was no difference between the groups regarding urine morphine levels (p = 0.859). The urine morphine/ codeine ratio was 6.2 in the 6-MAM-negative group, whilst it was 32.2 in the 6-MAM-positive group. In the blood samples, morphine and codeine concentrations were significantly correlated (r = 0.607; p = 0.006). In urine samples, correlations between morphine and codeine (r = 0.766; p &lt; 0.001), morphine and 6-MAM (r = 0.650; p &lt; 0.001), as well as codeine and 6-MAM (r = 0.620; p &lt; 0.001), were also significant. Conclusion. Analyses of 6-MAM and morphine/codeine ratio in blood and urine autopsy samples may be used as diagnostic tools to distinguish deaths related to the consumption of different opioid drugs.</jats:p>","journal":"Srpski arhiv za celokupno lekarstvo","year":2019,"id":29092,"datarank":0.20794415416798362,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.0,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":2,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":161213,"name":"Dijana Miric","orcid":null,"position":1,"is_corresponding":false},{"id":161214,"name":"Aleksandra Ilic","orcid":null,"position":2,"is_corresponding":false},{"id":161215,"name":"Suzana Matejic","orcid":"0000-0001-6422-5354","position":3,"is_corresponding":false},{"id":161216,"name":"Snezana Stevic","orcid":"0000-0003-2605-7913","position":4,"is_corresponding":false},{"id":161217,"name":"Zdravko Vitosevic","orcid":null,"position":5,"is_corresponding":false},{"id":161212,"name":"Vladimir Jaksic","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"24523987","pmcid":null,"openalex_id":"https://openalex.org/W2911895287","authors":[],"funders":[],"total_grants":0,"fwci":0.1331,"citation_percentile":0.37725632,"influential_citations":0,"citation_trend":[{"year":2019,"count":1},{"year":2024,"count":1},{"year":2026,"count":1}],"oa_status":"gold","license":"cc-by-nc","oa_locations":[{"url":"http://www.doiserbia.nb.rs/ft.aspx?id=0370-81791900003J","host_type":"journal"},{"url":"http://www.doiserbia.nb.rs/ft.aspx?id=0370-81791900003J","host_type":"GOLD"},{"url":"http://www.doiserbia.nb.rs/ft.aspx?id=0370-81791900003J","host_type":"publisher"},{"url":"https://doi.org/10.2298/sarh181005003j","host_type":"journal"},{"url":"https://doaj.org/article/819905012d05452885cd328241d3f9b2","host_type":"repository"}],"fields_of_study":["Forensic Toxicology and Drug Analysis","Opioid Use Disorder Treatment","Poisoning and overdose treatments","Medicine"],"mesh_terms":[],"keywords":["Codeine","Morphine","Urine","Medicine","Heroin","Opioid","Autopsy","Pharmacology","Internal medicine","Drug"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-06-08T22:38:36.190644Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}