Oxycodone is a strong
opioid drug commonly used to treat acute,
cancer, and chronic non-malignant
pain. In this study, all
oxycodone-related medico-legal cases where death had occurred in a hospital or
nursing home in Finland were investigated to determine the range of post-mortem (PM)
oxycodone blood concentrations in a therapeutic setting. All toxicology cases in which
oxycodone was detected in PM femoral blood during the 4-year period of 2016-2019 in Finland were retrieved from the national PM toxicology database. In this material, the 365 deceased hospital patient cases that met the study inclusion criteria were divided into four groups according to the cause and manner of death. The reference group of 121 fatal
oxycodone poisoning cases comprised two groups: those with verified associated
drug abuse and those without
drug abuse. The median
oxycodone concentration in PM blood was significantly higher in
cancer patients (0.10 mg/L) than in patients with recent surgery (0.07 mg/L) or other disease (0.06 mg/L) (p < 0.05). In addition, the median
oxycodone concentration was significantly lower in all hospital patient groups than in the
poisoning groups, the latter displaying 0.38 mg/L (abuse) and 0.64 mg/L (no abuse) (p < 0.001). This study shows that half of the subjects in the
cancer patient group had PM blood
oxycodone concentrations above the typical clinical therapeutic plasma concentration range (0.005-0.10 mg/L). Appropriate medication of hospitalized surgery and
cancer patients can result in concentrations of up to 0.2 and 0.6 mg/L, respectively, while higher concentrations are exceptional.