A COMPARISON OF BLOOD TOXICOLOGY OF HEROIN-RELATED DEATHS AND CURRENTHEROIN USERS IN SYDNEY, AUSTRALIA

Blood toxicology results for deaths attributed to heroin overdose duri ng 1995 in the South Western Sydney (SWS) region (n = 39) were compare d with those of a sample of 100 current SWS heroin users who had injec ted within the preceding 24 h. Heroin-related deaths had a higher medi an concentration of morphine than current heroin users (0.35 versus 0. 09 mg/I). However, there was substantial overlap between the blood mor phine concentrations of the two groups, ranging from 0.08-1.45 mg/l. T his range incorporated 90% of heroin-related deaths. A third of curren t users had morphine concentrations over twice the toxic blood morphin e concentration employed by the analytical laboratories, and 7% had mo rphine levels higher than the median recorded for fatal cases. Alcohol was detected in 51% of fatal cases (median = 0.10 g/100 ml) compared with 1% of current heroin user. There was a significant negative corre lation among fatal cases between blood morphine and blood alcohol conc entrations (r(s) = -0.41). There was no significant difference between groups in the proportions of subjects positive for blood benzodiazepi nes. The results raise questions about the mechanisms of death in what are termed overdoses, and about the role of alcohol in these fataliti es. (C) 1997 Elsevier Science Ireland Ltd.