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In this study, all oxycodone-related medico-legal cases where death had occurred in a hospital or nursing home in Finland were investigated to determine the range of post-mortem (PM) oxycodone blood concentrations in a therapeutic setting. All toxicology cases in which oxycodone was detected in PM femoral blood during the 4-year period of 2016\u20132019 in Finland were retrieved from the national PM toxicology database. In this material, the 365 deceased hospital patient cases that met the study inclusion criteria were divided into four groups according to the cause and manner of death. The reference group of 121 fatal oxycodone poisoning cases comprised two groups: those with verified associated drug abuse and those without drug abuse. The median oxycodone concentration in PM blood was significantly higher in cancer patients (0.10\u00a0mg\/L) than in patients with recent surgery (0.07\u00a0mg\/L) or other disease (0.06\u00a0mg\/L) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). In addition, the median oxycodone concentration was significantly lower in all hospital patient groups than in the poisoning groups, the latter displaying 0.38\u00a0mg\/L (abuse) and 0.64\u00a0mg\/L (no abuse) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). This study shows that half of the subjects in the cancer patient group had PM blood oxycodone concentrations above the typical clinical therapeutic plasma concentration range (0.005\u20130.10\u00a0mg\/L). Appropriate medication of hospitalized surgery and cancer patients can result in concentrations of up to 0.2 and 0.6\u00a0mg\/L, respectively, while higher concentrations are exceptional.<\/jats:p>","DOI":"10.1007\/s00414-022-02890-2","type":"journal-article","created":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T16:05:53Z","timestamp":1662480353000},"page":"1577-1583","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Post-mortem oxycodone blood concentrations of hospitalized cancer and surgery patients compared with fatal poisonings"],"prefix":"10.1007","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5721-2827","authenticated-orcid":false,"given":"Pirkko","family":"Kriikku","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4899-605X","authenticated-orcid":false,"given":"Eija","family":"Kalso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5790-1473","authenticated-orcid":false,"given":"Ilkka","family":"Ojanper\u00e4","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,9,6]]},"reference":[{"key":"2890_CR1","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1016\/j.tips.2013.02.001","volume":"34","author":"KT Olkkola","year":"2013","unstructured":"Olkkola KT, Kontinen VK, Saari TI, Kalso EA (2013) Does the pharmacology of oxycodone justify its increasing use as an analgesic? 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