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The amount of fibrous connective tissue (FCT<\/jats:styled-content>) in the myocardium was determined by using the morphometric software LUCIA N<\/jats:styled-content>et version 1.16.2\u00a9<\/jats:sup>, L<\/jats:styled-content>aboratory I<\/jats:styled-content>maging, with NIS E<\/jats:styled-content>lements 3.0\u00ae<\/jats:sup>.<\/jats:p><\/jats:sec>Findings<\/jats:title>Drug analysis revealed that 67.11% were polydrug users and the same proportion was classified as heroin addicts (6\u2010monoacetylmorphine, 6\u2010MAM<\/jats:styled-content>)\u201432.89% were users of pure heroin. In 76.32% of DRD<\/jats:styled-content> cases, codeine was detected. Only 2.63% consumed cocaine. The mean morphine concentrations were 389.03\u2009ng\/g in the cerebellum and 275.52\u2009ng\/g in the medulla oblongata, respectively. Morphometric analysis exhibited a strong correlation between DRD<\/jats:styled-content> and myocardial fibrosis. The mean proportion of FCT<\/jats:styled-content> content in the drug group was 7.6\u2009\u00b1\u20092.9% (females: 6.30\u2009\u00b1\u20092.19%; males: 7.91\u2009\u00b1\u20093.01%) in contrast to 5.2\u2009\u00b1\u20091.7% (females: 4.45\u2009\u00b1\u20091.23%; males: 5.50\u2009\u00b1\u20091.78%) in the control group, indicating a significant difference (P<\/jats:italic>\u2009=\u20090.0012), and a significant difference in the amount of FCT<\/jats:styled-content> between females and males (P<\/jats:italic>\u2009=\u20090.0383). There was no significant interaction of age and FCT<\/jats:styled-content> (P<\/jats:italic>\u2009=\u20090.8472).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>There is a long\u2010term risk of cardiac dysfunction following chronic illicit drug abuse with opioids as a principal component. Regular cardiological examination of patients receiving substitution treatment with morphine is strongly recommended.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.12106","type":"journal-article","created":{"date-parts":[[2013,1,8]],"date-time":"2013-01-08T19:10:49Z","timestamp":1357672249000},"page":"1287-1295","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Micromorphological changes in cardiac tissue of drug\u2010related deaths with emphasis on chronic illicit opioid abuse"],"prefix":"10.1111","volume":"108","author":[{"given":"Monika H.","family":"Seltenhammer","sequence":"first","affiliation":[{"name":"Department of Forensic Medicine Medical University Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Marchart","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine Medical University Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Paula","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine Medical University Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Kordina","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine Medical University Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaus","family":"Klupp","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine Medical University Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine Medical University Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Fitzl","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine Medical University Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele U.","family":"Risser","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine Medical University Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,4,12]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"United Nations Office on Drugs and Crime (UNODC).World Drug Report.2011.New York:United Nations Publication Sales no. 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