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In 26 deaths in which acetyl fentanyl or fentanyl were not involved, free and total peripheral blood morphine concentrations were consistent with fatal heroin intoxications, averaging 0.16 mg\/L and 0.35 mg\/L, respectively. In the heroin cases with fentanyl present (n=7), the average free morphine concentration was 0.040 mg\/L, the average total morphine concentration was 0.080 mg\/L, and the average fentanyl concentration was 0.012 mg\/L. In the cases with heroin, fentanyl, and acetyl fentanyl (n=3), the average free morphine concentration was 0.010 mg\/L, the average total morphine concentration was 0.030 mg\/L, the average fentanyl concentration was 0.018 mg\/L, and the average acetyl fentanyl concentration was 0.008 mg\/L. In the cases involving only acetyl fentanyl (without heroin or fentanyl, n=4), the average acetyl fentanyl concentration was 0.47 mg\/L and the average acetyl norfentanyl concentration was 0.053 mg\/L. The presented cases, with associated drug concentrations, case histories, demographics, and causes and manners of death may help provide assistance with the interpretation of the postmortem findings. Based on case circumstances, autopsy results, and toxicology results, it is evident that fentanyl and\/or acetyl fentanyl, when present, contributed to the cause of death.<\/jats:p>","DOI":"10.23907\/2015.072","type":"journal-article","created":{"date-parts":[[2017,4,11]],"date-time":"2017-04-11T17:59:48Z","timestamp":1491933588000},"page":"676-689","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":25,"title":["Postmortem Toxicology Findings of Acetyl Fentanyl, Fentanyl, and Morphine in Heroin Fatalities in Tampa, Florida"],"prefix":"10.1177","volume":"5","author":[{"given":"Julia","family":"Pearson","sequence":"first","affiliation":[{"name":"Hillsborough County Medical Examiner Department"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Poklis","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, Virginia Commonwealth University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alphonse","family":"Poklis","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, Department of Pathology, and Department of Forensic Science, Virginia Commonwealth University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Pathology, and Department of Forensic Science, Virginia Commonwealth University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Mainland","sequence":"additional","affiliation":[{"name":"Hillsborough County Medical Examiner Department"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Hair","sequence":"additional","affiliation":[{"name":"Hillsborough County Medical Examiner Department"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Devers","sequence":"additional","affiliation":[{"name":"Hillsborough County Medical Examiner Department"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leszek","family":"Chrostowski","sequence":"additional","affiliation":[{"name":"Hillsborough County Medical Examiner Department"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elise","family":"Arbefeville","sequence":"additional","affiliation":[{"name":"Hillsborough County Medical Examiner Department"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Merves","sequence":"additional","affiliation":[{"name":"Hillsborough County Medical Examiner Department"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,12,1]]},"reference":[{"issue":"39","key":"bibr1-2015.072","first-page":"849","volume":"63","author":"Rudd R.A.","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"bibr2-2015.072","unstructured":"SlavovaS., BunnT., LambertJ. Drug overdose deaths in Kentucky, 2000-2013 [Internet]. Lexington (KY): Kentucky Injury Prevention and Research Center; 2015 Mar [cited 2015 Jun 4]. 17 p. Available from: http:\/\/www.mc.uky.edu\/kiprc\/projects\/ddmarpdak\/pdf\/KyDrugOverdoseDeaths-2000-2013.pdf."},{"key":"bibr3-2015.072","unstructured":"Drugs identified in deceased persons by Florida medical examiners - 2013 annual report [Internet]. Tallahassee: Florida Department of Law Enforcement; 2014 Oct [cited 2015 Jun 4]. 49 p. Available from: http:\/\/www.fdle.state.fl.us\/Content\/getdoc\/05c6ff97-00cc-49b2-9ca5-5dacd4539b1a\/2013-Annual-Drug-Report-(2).aspx."},{"key":"bibr4-2015.072","unstructured":"Drugs identified in deceased persons by Florida medical examiners - interim report 2014 [Internet]. Tallahassee: Florida Department of Law Enforcement; 2015 Apr [cited 2015 Jun 4]. 32 p. 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