Every year, thousands of suspicious deaths are accounted for by an overdose of opioids. Occasionally all traditional matrices are unavailable due to decomposition. Skeletal tissue may pose a valid alternative. However, reference data on post-mortem concentrations in bone tissue and bone marrow (BM) is sparse. Therefore, a liquid chromatography tandem mass spectrometry method was developed and fully validated for the analysis of four opioids and two metabolites (tramadol, O-desmethyltramadol, morphine, fentanyl, norfentanyl, codeine) in bone tissue and BM. Sample preparation was performed using solid phase extraction (BM), methanolic extraction (bone) and a protein precipitation (whole blood). All validation parameters were successfully fulfilled. This method was applied to analyze 22 forensic cases involving opioids. All six opioids were proven to be detectable and quantifiable in all specimens sampled. When tramadol blood concentrations were correlated with bone concentrations, a linear trend could be detected. The same was seen between tramadol blood and BM concentration. A similar linear trend was seen when correlating codeine blood concentration with bone and BM concentration. Although some variability was detected, the same linear trend was seen for morphine. For fentanyl and norfentanyl, the sample size was too small to draw conclusions, regarding correlation. As far as the authors know this is the first-time fentanyl and norfentanyl are quantified in skeletal tissue. In conclusion, due to the absence of reference data for drugs in skeletal tissue, these findings are a step forward toward a more thorough understanding of drug concentration found in post-mortem skeletal tissue.

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骨骼组织中阿片类药物和代谢物的尸检分析

每年，过量服用阿片类药物会导致数千起可疑死亡事件。有时，由于分解，所有传统矩阵都不可用。骨骼组织可能是一个有效的替代方案。然而，关于骨组织和骨髓 (BM) 中的死后浓度的参考数据很少。因此，开发并充分验证了液相色谱串联质谱法用于分析骨组织和 BM 中的四种阿片类药物和两种代谢物（曲马多、O-去甲基曲马多、吗啡、芬太尼、去甲芬太尼、可待因）。使用固相萃取 (BM)、甲醇萃取（骨）和蛋白质沉淀（全血）进行样品制备。所有验证参数均已成功满足。该方法应用于分析 22 起涉及阿片类药物的法医案件。所有六种阿片类药物都被证明在所有取样样本中都是可检测和可量化的。当曲马多血液浓度与骨浓度相关时，可以检测到线性趋势。在曲马多血液和 BM 浓度之间观察到相同的情况。当将可待因血液浓度与骨和 BM 浓度相关时，观察到类似的线性趋势。尽管检测到了一些变异性，但吗啡也出现了相同的线性趋势。对于芬太尼和去甲芬太尼，样本量太小，无法就相关性得出结论。据作者所知，这是首次在骨骼组织中对芬太尼和去甲芬太尼进行量化。总之，由于缺乏骨骼组织中药物的参考数据，