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[deleted] t1_j6djvtz wrote

[removed]

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bynarie OP t1_j6dk7g5 wrote

Yea we have a toxicology report thats what im trying to get a guess of what dose it is.

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shoktar t1_j6ekzim wrote

the problem is that people can have different genes for the expression of drug-metabolizing enzymes.

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bynarie OP t1_j6dkvpp wrote

The postmortem toxicology report suggests a death of drug overdose, with 0.33ug/ml blood concentration of hydrocodone. So thats what we were trying to estimate.

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aziridine86 t1_j6dpq0u wrote

You need an estimate of when the hydrocodone was taken, and an assumption that it was taken as a single dose. Also need to know the route of administration. Probably oral for hydrocodone. Then google "hydrocodone pharmacokinetics" and compare some graphs. May need to convert units also.

Looks like typical concentrations are around 10-100 ng/mL following normal doses in the 10-60 mg range. A blood concentration of 330 ng/mL is quite high based on very brief research.

Published papers on postmortem concentration in hydrocodone overdose give numbers around 0.4-0.5 mg/L (ug/mL) so overdose sounds plausible here, probably took a dose of >100 mg hydrocodone if I had to guess.

This is not legal or medical advice FYI

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bynarie OP t1_j6dubgg wrote

Thank you. Yea, and there were also other drugs in the system, specifically diphenhydramine and cyclobenzaprine. I know there's just no way to figure it out. But 100mg of hydrocodone doesnt seem like a lethal dose for a person with tolerance.

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Wyvernz t1_j6dxant wrote

Sedating drugs can work synergistically as well, so while 100 mg probably wouldn’t be lethal in someone with significant tolerance if you add other sedating meds like diphenhydramine and cyclobenzaprine the overall level of sedation may push them over the edge.

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preownedliver t1_j6dw8pw wrote

Each person is different, but I happen to know that for a healthy 6’5”, 200lb 27yr old male, who was a moderate opiate addict, a dose of 25 10mg pills (250 mg hydrocodone) taken orally of hydrocodone did not cause overdose. Their were ill effects, but no loss of consciousness and no hospitalization. Again, each person’s chemistry is going to be different, but that did happen.

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Scarlet- t1_j6e89lg wrote

What’s the age of the person?

100mg is a bit high. Even for someone with tolerance. I personally have never seen a prescription for Norco 10-325 to be taken 10 pills at a time.

But two major concerns present itself:

  1. Respiratory depression induced by opioids
  2. Liver damage caused by the acetaminophen in the Norco; assuming you are from the US where just getting hydrocodone by itself is not really a thing, minus special cases.
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SagginDragon t1_j6dxq51 wrote

Pretty sure opiate levels continue going down in the blood for a while after death

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sutchatweet t1_j6dow2r wrote

This interesting paper might help, although I’ve not read more than the abstract. To back calculate how much was taken you’d need a lot more information including time from dose, was it a single dose or taken repeatedly over time as well as height, weight, fat distribution etc

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mohirl t1_j6fd26g wrote

Surely time is a large factor?

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bruce_kwillis t1_j6fftgi wrote

Correct.

OP is asking the wrong question. Based on what day provided it seems in line with an overdose, especially with the other drugs involved, unless the person was a known addict.

From a tox report you only have a snapshot at the one particular time point. You need multiple time points to even potentially guess the starting dose along with an extensive patient history.

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