ISSN: 2320-5407 Int. J. Adv. Res. 10(08), 1195-1201 1195 Journal Homepage: -www.journalijar.com Article DOI:10.21474/IJAR01/15287 DOI URL: http://dx.doi.org/10.21474/IJAR01/15287 RESEARCH ARTICLE THE STABILITY OF HEROIN METABOLITES AND ADULTERANTS IN BLOOD TO EVALUATE ROLE OF THE STABILITY ON POSTMORTEM REDISTRIBUTION Dr. İsmail Ethem Gören 1 and Dr. Nebile Daglioglu 2 1. Doctor (PhD), Department of Forensic Medicine, Faculty of Medicine, Cukurova University, Adana, Türkiye. 2. Associate Professor, Department of Forensic Medicine, Faculty of Medicine, Cukurova University, Adana, Türkiye. …………………………………………………………………………………………………….... Manuscript Info Abstract ……………………. ……………………………………………………………… Manuscript History Received: 27 June 2022 Final Accepted: 30 July 2022 Published: August 2022 Key words:- Instability, Heroin, Morphine, Postmortem, Toxicology, Fentanyl, Adulterants The present study aimed to investigate the stability of morphine, morphine-3-β-glucuronide (M3G), morphine-6-β-glucuronide (M6G), 6-acetylmorphine (6-AM) from heroin metabolites, and codeine, codeine-6-glucuronide, nor-codeine, fentanyl, norfentanyl, paracetamol, caffeine from its adulterants at room temperature for 24 hours in order to understand the effect of instability in postmortem redistribution (PMR). The heroin metabolites and adulterants were spiked into the control blood sample with the standard addition method. Then they were kept at room temperature for 4 hours and 24 hours and the blood samples were prepared by liquid-liquid extraction method. The prepared samples were analyzed using the validated analytical method with a liquid-chromatography-tandem mass spectrometry. According to the results of this study, no significant changes were observed in the analyte concentrations in the 4- and 24-hour postmortem blood, and it is thought that the other mechanisms may be more responsible than the instability of analytes for the significant concentration changes in PMR. Copy Right, IJAR, 2022,. All rights reserved. …………………………………………………………………………………………………….... Introduction:- Heroin is an opioid drug that is most commonly used and has a high mortality rate globally each year. According to CDC (Centre for Disease Control and Prevention) data, around 143,000 people died from high-dose heroin in the USA between 1999 and 2020 1 . After administration via intravenous route, it is rapidly deacetylated to 6-AM and then hydrolyzed to morphine. The half-life of heroin, which is rarely detectable in human samples, averages 2–6 minutes. The half-life of 6-AM is on average 6–25 minutes, and its detection in the blood can indicate that heroin has been administered recently 2 . 6-AM is then hydrolyzed to morphine. The accurate elucidation of the death mechanism of heroin-related deaths poses a challenge in forensic toxicology. Therewith, the changing of adulterant composition including synthetic opioids such as fentanyl and its derivatives mixed into heroin in order to increase profit by increasing the amount of substance, increase the desired effects of heroin and facilitate its administration to the body, is considered among the possible causes of the opioid epidemic in recent years 3,4 . The most common drugs in the mixture called street heroin are paracetamol and caffeine 5 . In recent years, dextromethorphan has been added to these drugs. Tittarelli et al. determined the composition of the street heroin seized by the police to update the Italian National Early Warning System launched in 2010 and the most frequently Corresponding Author:- İsmail Ethem Gören Address:- Department of Forensic Medicine, Faculty of Medicine, Cukurova University, Adana.