Intravenous misuse of slow-release oral morphine capsules: how much morphine is injected?

Original research
by
Bertin, Célian et al

Release Date

2023

Geography

France

Language of Resource

English

Full Text Available

Yes

Open Access / OK to Reproduce

Yes

Peer Reviewed

Yes

Objective

The aim of our study was to determine the amounts of morphine actually injected, according to the different preparation modalities described by people who inject morphine from morphine sulfate capsules containing sustained-release microbeads (Skenan®) and the harm reduction equipment made available to them.

Findings/Key points

No procedure for dissolving Skenan® led to the complete dissolution of the morphine it contains. Whatever the variations in preparation conditions, the extraction rates of the 200 mg morphine capsules were lower than those of 100 mg, without the risk reduction filters adversely impacting morphine extraction. Offering an injectable substitution to persons who inject morphine would make it possible to reduce the risks and damage, particularly overdoses, associated with variations in dosage due to preparation methods.

Design/methods

Different morphine syringes were prepared by varying the dosage of the capsule (100 or 200 mg), the temperature of the dissolving water before adding morphine, ambient (≈ 22 °C) or heat (≈ 80 °C) and four filtration devices: risk reduction Steribox® cotton, risk reduction filter “Sterifilt®”, “Wheel” filter and cigarette filter. The quantification of the morphine in the syringe body was carried out by liquid phase chromatography coupled with a mass spectrometry detector.

Keywords

Harm reduction
Injecting drugs
Safer supply