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Opioid overdose mortality in Kansas, 2001-2011: toxicologic evaluation of intent.
J Anal Toxicol. 2013 Nov-Dec; 37(9):629-35.JA

Abstract

Drug concentration is a factor in the determination of the manner of death, but considerable overlap exists between therapeutic and toxic concentrations. This study aims to quantify opioid mortality in Kansas from use of fentanyl, methadone and oxycodone and to evaluate utility of drug concentrations for the determination of the manner of death. Cases referred to a forensic pathology practice in Kansas for autopsy from 1 January 2001 to 31 December 2011 were considered. The criterion for inclusion was detection of fentanyl, methadone and/or oxycodone in postmortem toxicology. Of 9,789 cases, 3,315 had positive toxicology: 180 of fentanyl, 299 of methadone and 310 of oxycodone. There were 207 single opioid fatalities, 264 polydrug overdoses and 318 deaths where an opioid was present but not contributory to the mechanism of death. In line with published studies, incidence of opioid overdose deaths increased over the time of the study. Drug concentrations within each cause and manner of death covered broad ranges. Non-natural and natural manners had less overlap than existed within non-natural manners in limited comparisons. This study shows that drug concentration is independent of manner for non-natural deaths and although insufficient to identify intent, can provide a guideline in differentiating non-natural from natural deaths.

Authors+Show Affiliations

1 Frontier Forensics Midwest, LLC, 40 S. 18th St., Kansas City, KS 66102, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24123621

Citation

Okic, Merisa, et al. "Opioid Overdose Mortality in Kansas, 2001-2011: Toxicologic Evaluation of Intent." Journal of Analytical Toxicology, vol. 37, no. 9, 2013, pp. 629-35.
Okic M, Cnossen L, Crifasi JA, et al. Opioid overdose mortality in Kansas, 2001-2011: toxicologic evaluation of intent. J Anal Toxicol. 2013;37(9):629-35.
Okic, M., Cnossen, L., Crifasi, J. A., Long, C., & Mitchell, E. K. (2013). Opioid overdose mortality in Kansas, 2001-2011: toxicologic evaluation of intent. Journal of Analytical Toxicology, 37(9), 629-35. https://doi.org/10.1093/jat/bkt085
Okic M, et al. Opioid Overdose Mortality in Kansas, 2001-2011: Toxicologic Evaluation of Intent. J Anal Toxicol. 2013 Nov-Dec;37(9):629-35. PubMed PMID: 24123621.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Opioid overdose mortality in Kansas, 2001-2011: toxicologic evaluation of intent. AU - Okic,Merisa, AU - Cnossen,Leslie, AU - Crifasi,Joseph A, AU - Long,Christopher, AU - Mitchell,Erik K, PY - 2013/10/15/entrez PY - 2013/10/15/pubmed PY - 2013/12/16/medline SP - 629 EP - 35 JF - Journal of analytical toxicology JO - J Anal Toxicol VL - 37 IS - 9 N2 - Drug concentration is a factor in the determination of the manner of death, but considerable overlap exists between therapeutic and toxic concentrations. This study aims to quantify opioid mortality in Kansas from use of fentanyl, methadone and oxycodone and to evaluate utility of drug concentrations for the determination of the manner of death. Cases referred to a forensic pathology practice in Kansas for autopsy from 1 January 2001 to 31 December 2011 were considered. The criterion for inclusion was detection of fentanyl, methadone and/or oxycodone in postmortem toxicology. Of 9,789 cases, 3,315 had positive toxicology: 180 of fentanyl, 299 of methadone and 310 of oxycodone. There were 207 single opioid fatalities, 264 polydrug overdoses and 318 deaths where an opioid was present but not contributory to the mechanism of death. In line with published studies, incidence of opioid overdose deaths increased over the time of the study. Drug concentrations within each cause and manner of death covered broad ranges. Non-natural and natural manners had less overlap than existed within non-natural manners in limited comparisons. This study shows that drug concentration is independent of manner for non-natural deaths and although insufficient to identify intent, can provide a guideline in differentiating non-natural from natural deaths. SN - 1945-2403 UR - https://www.unboundmedicine.com/medline/citation/24123621/Opioid_overdose_mortality_in_Kansas_2001_2011:_toxicologic_evaluation_of_intent_ L2 - https://academic.oup.com/jat/article-lookup/doi/10.1093/jat/bkt085 DB - PRIME DP - Unbound Medicine ER -