Abstract
Toxicological analysis is a complex set of tasks aiming to estimate how much time has elapsed since a drug was last consumed or to inform about its chronic consumption. It is also worth paying attention to the fact of using psychoactive substances induce euphoria or increase physical energy. The use of opioids to alleviate pain is complicated by the risk of severe adverse events and the large variability in dose requirements. Pharmacogenetics could be used to adapt pain medication based on an individual’s genetic background. Many potential genetic markers related to xenobiotics metabolism have been described. Such predictors are especially of value for neonates and young children, in which case the assessment of efficacy is complicated by imprecise/poor communication. The knowledge of opioids metabolism is essential also for older patients and those with comorbidities, who receive multiple medications and may have impaired renal and hepatic function.
Highlights
According to UNODC (United Nations Office on Drugs and Crime, 2017) World Drug Report 2017 in 2015 0.27 to 0.49% of global adults population (13-24 million people) had opiates use history, while for opioids were 0.59 to 0.88%
Called opioid crisis resulted in an epidemic of overdose deaths and become “national public health emergency”, as declared even politicians [1,2,3]
Interpretation of toxicological analysis allows to assess the period of substance ingestion and the time since opioids were used last by addicted individual
Summary
According to UNODC (United Nations Office on Drugs and Crime, 2017) World Drug Report 2017 in 2015 0.27 to 0.49% of global adults population (13-24 million people) had opiates use history, while for opioids were 0.59 to 0.88% (between 28 and 43 millions). Opioids play important role in acute and chronic pain management [5]. Pharmacogenetic markers in this instance help to tailor clinical use of opioids, including Codeine, Tramadol, Tapentadol, Morphine, Oxycodone, Hydrocodone, Buprenorphine, Methadone [6]. Heroin use Clinical and forensic toxicologists are confronted with establishing heroin use on a daily basis This intoxicant and its metabolite, 6-acetylmorphine, have very short life-time in the organism. Alternative approach to reveal heroine ingestion is a detection of other alkaloids contaminating illegally produced drug doses. Presence of poppy opium ingredients, e.g. codeine, noscapine, papaverine or their metabolites in the suspect-derived samples suggest heroin use
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