{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:51:22Z","timestamp":1790661082633,"version":"4.1.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T00:00:00Z","timestamp":1708992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Available literature demonstrates that methadone is prone to moderate postmortem redistribution, but subject to high interindividual variability in the central to peripheral blood concentration ratios (C\/P). In this case series, 10 cases of chronic methadone users displaying C\/P\u2009&amp;lt;\u20091 (range 0.26\u20130.82) are described. Femoral, cardiac and ante-mortem blood concentrations of methadone and its metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) are reported for all cases, as well as sex, age, case history, results of the pathological investigation, other toxicological findings and cause and manner of death. EDDP blood concentrations, similar in both central and peripheral blood, as well as antemortem blood concentration results in Case 4, demonstrate that this atypical C\/P\u2009&amp;lt;\u20091 finding is attributable to postmortem changes and not analytical or pre-analytical artifacts. Case 4 is a particularly instructive example, with femoral blood concentration (966\u2009ng\/mL) approximately twice as high as cardiac blood (499\u2009ng\/mL) and ante-mortem blood (418\u2009ng\/mL, collected 38\u2009min prior to death)\u2014clearly demonstrating that cardiac blood methadone concentration is more representative of the antemortem blood concentration in this case. In Case 4 and four others, toxicological interpretation based on femoral blood concentration alone would have been misleading. Based on these results and evidence from the literature, it is hypothesized that methadone bioaccumulates in the tissues of chronic users and redistributes from thigh tissues into femoral blood, increasing the concentration postmortem. This case series highlights how femoral blood is not always preserved from postmortem changes and that the analysis of multiple blood sources is necessary to avoid a misleading toxicological interpretation\u2014particularly for cases of chronic methadone users.<\/jats:p>","DOI":"10.1093\/jat\/bkae016","type":"journal-article","created":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T16:07:43Z","timestamp":1708963663000},"page":"343-349","source":"Crossref","is-referenced-by-count":6,"title":["Atypical postmortem redistribution in chronic methadone consumers"],"prefix":"10.1093","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2558-8598","authenticated-orcid":false,"given":"B\u00e9atrice","family":"Garneau","sequence":"first","affiliation":[{"name":"Department of Toxicology, Laboratoire de sciences judiciaires et de m\u00e9decine l\u00e9gale , 1701 Parthenais St., Montr\u00e9al, Qu\u00e9bec H2K 3S7,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Toxicology, Laboratoire de sciences judiciaires et de m\u00e9decine l\u00e9gale , 1701 Parthenais St., Montr\u00e9al, Qu\u00e9bec H2K 3S7,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Motard","sequence":"additional","affiliation":[{"name":"Department of Toxicology, Laboratoire de sciences judiciaires et de m\u00e9decine l\u00e9gale , 1701 Parthenais St., Montr\u00e9al, Qu\u00e9bec H2K 3S7,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7373-656X","authenticated-orcid":false,"given":"Brigitte","family":"Desharnais","sequence":"additional","affiliation":[{"name":"Department of Toxicology, Laboratoire de sciences judiciaires et de m\u00e9decine l\u00e9gale , 1701 Parthenais St., Montr\u00e9al, Qu\u00e9bec H2K 3S7,","place":["Canada"]},{"name":"Department of Environmental and Occupational Health, Universit\u00e9 de Montr\u00e9al School of Public Health , PO Box 6128, Station Centre-ville, Montr\u00e9al, Qu\u00e9bec H3C 3J7,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Bouchard","sequence":"additional","affiliation":[{"name":"Department of Toxicology, Laboratoire de sciences judiciaires et de m\u00e9decine l\u00e9gale , 1701 Parthenais St., Montr\u00e9al, Qu\u00e9bec H2K 3S7,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Mireault","sequence":"additional","affiliation":[{"name":"Department of Toxicology, Laboratoire de sciences judiciaires et de m\u00e9decine l\u00e9gale , 1701 Parthenais St., Montr\u00e9al, Qu\u00e9bec H2K 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