Evidence map›Paper›PMID 41913073›Full record

ArticleBritish journal of clinical pharmacology2026

Mapping opioid exposure through prescription data and postmortem analysis of opioid drugs in multiple tissues.

Niamh Higgins, Alan Wells, Nimish Patel, Nicole Muttera, Mattia Trunfio, Alessandra Manca, Amedeo De Nicolò, Micol Ferrara, Stefano Bonora, Jessica Cusato and 14 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Niamh HigginsSkaggs School of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice and Sciences, University of California San Diego, La Jolla, California, USA.ORCID https://orcid.org/0000-0002-5947-5209
Alan WellsDivision of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, California, USA.
Nimish PatelSkaggs School of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice and Sciences, University of California San Diego, La Jolla, California, USA.ORCID https://orcid.org/0000-0003-0921-549X
Nicole MutteraAntiviral Research Center (AVRC), University of California San Diego, San Diego, California, USA.
Mattia TrunfioDivision of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, California, USA.
Alessandra MancaLaboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Turin, Italy.
Amedeo De NicolòLaboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Turin, Italy.
Micol FerraraUnit of Infectious Diseases, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Turin, Italy.ORCID https://orcid.org/0000-0003-0377-9630
Stefano BonoraUnit of Infectious Diseases, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Turin, Italy.
Jessica CusatoLaboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Turin, Italy.
Alice PalermitiLaboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Turin, Italy.
Antonio D'AvolioLaboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Turin, Italy.ORCID https://orcid.org/0000-0002-1321-4126
Marissa BorochoffDivision of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, California, USA.
Patricia K RiggsDivision of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, California, USA.
Elizabeth HastieDivision of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, California, USA.ORCID https://orcid.org/0000-0001-6587-6968
Rabia S AtayeeSkaggs School of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice and Sciences, University of California San Diego, La Jolla, California, USA.
Stephanie SolsoAntiviral Research Center (AVRC), University of California San Diego, San Diego, California, USA.
Cheryl DullanoDivision of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, California, USA.
Vanessa Gomez-MorenoDivision of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, California, USA.
Tara TenenbaumDivision of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, California, USA.
Robert DeissAntiviral Research Center (AVRC), University of California San Diego, San Diego, California, USA.
Davey M SmithAntiviral Research Center (AVRC), University of California San Diego, San Diego, California, USA.
Antoine ChaillonDivision of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, California, USA.
Sara GianellaDivision of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, California, USA.

Funding

VirologyP30AI036214 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SUSAN JANET LITTLE · 1994 to 2026
$78.4M
Project-004P01AI169609 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI David Mitchell Smith · 2022 to 2026
$10.6M
HOPE Training GrantT32AI007384 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Sara Gianella Weibel, Scott L Letendre · 1990 to 2026
$9.7M
Brain Myeloid Cells are Sources of HIV-associated Damage and Viral DispersalR01DA055491 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI CHAILLON, ANTOINE · 2021 to 2025
$3.6M
Disentangling the HIV/opioid intertwined mechanisms on mitochondrial mediated inflammasome activation, neurotoxicity and targeting strategies: In vivo and in vitro analyses of fresh human brainR01DA062278 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Antoine Chaillon, Jerel Adam Fields · 2025 to 2026
$1.5M
NIAID NIH HHS P01 AI169609NIAID NIH HHS P30 AI036214NIAID NIH HHS T32 AI007384NIDA NIH HHS R01 DA055491NIDA NIH HHS R01 DA062278NIH HHS DA062278NIH HHS P01 AI169609NIH HHS R01 DA055491The James B. Pendleton Charitable Trust
6 · The paper itself

Abstract

background and purposeAlthough opioids are central to end of life (EoL) care, tissue-level opioid exposure remains poorly understood. The objective of this study was to characterize the relationship between prescription-derived morphine equivalent daily dose (MEDD) and measured morphine concentrations across multiple organs. EXPERIMENTAL APPROACH: We analysed data from the Last Gift cohort, a community-centred HIV research rapid autopsy programme. Cumulative MEDD for the final 7 and 30 days before death (MEDD-7, MEDD-30) was calculated using prescription data. Postmortem samples from multiple organs were analysed using ultra-high-performance liquid chromatography with tandem mass spectrometry to quantify opioids. Mixed-effects regression models and Pearson correlations evaluated relationships between MEDD and tissue morphine concentrations. KEY

resultsAmong 261 samples from 27 participants (median age 65 years), 96% had ≥1 detectable opioid. Morphine was most frequently prescribed (78%), followed by fentanyl (41%), hydromorphone (37%), and oxycodone (33%). Median MEDD-7 and MEDD-30 were 940 (IQR 158-3481) and 3430 (IQR 563-9972), respectively. Morphine concentrations were highest in the ascending colon, kidney, duodenum, and liver, and lowest in adipose tissue and cerebrospinal fluid. Tissue morphine concentrations correlated with both MEDD-7 and MEDD-30 (e.g., medulla r = .80; spinal cord r = .77; parietal cortex r = .72; all p < .01). In adjusted mixed-effects models, each 10-fold increase in MEDD-7/-30 predicted a 3.7- to 3.8-fold increase in tissue morphine concentration. CONCLUSION AND IMPLICATIONS: Prescription-based morphine exposure was strongly associated with morphine tissue concentrations across multiple organs, providing a quantitative framework for integrating pharmacologic data into EoL research.

Indexed as

Analgesics, OpioidMorphineAgedAutopsyChromatography, High Pressure LiquidFemaleHumansMaleMiddle AgedTandem Mass SpectrometryTerminal CareTissue DistributionAnalgesics, OpioidMorphinedrug distributionend‐of‐life researchHIVmorphineopioid analgesicspharmacokineticstranslational pharmacology

Identifiers

PMID41913073
PMCPMC13420920

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.