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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 27, Number 7, October 2003,
pp. 527-529
CASE REPORT: Buprenorphine in Drug-Facilitated Sexual
Abuse: A Fatal Case Involving a 14-Year-Old Boy
Pascal Kintz, Marion Villain, Antoine Tracqui,
Vincent Cirimele, and Bertrand Ludes
Institut de Médecine Légale, 11 rue Humann, F-67000 Strasbourg,
France
The first case involving repetitive sexual abuse linked to the
use of buprenorphine is reported. Under the tradename Subutex®, buprenorphine
is largely used for the substitution management of opiate-dependent individuals,
but it can also be easily found on the black market. A 14-year-old boy was
found dead at the home of a well-known sex offender of minors. At the autopsy,
no particular morphological changes were noted, except for pulmonary and visceral
congestion. There was no evidence of violence, and no needle marks were found
by the pathologist. Toxicological analyses, as achieved by liquid chromatography–mass
spectrometry, demonstrated both recent and repetitive buprenorphine exposure
in combination with nordiazepam. Buprenorphine concentrations were 1.1 ng/mL
and 23 pg/mg in blood and hair, respectively. The boy’s death was attributed
to accidental asphyxia in a facilitated repetitive sexual abuse situation due
to the combination of buprenorphine and benzodiazepines, even at therapeutic
concentrations. The use of buprenorphine as a sedative drug was not challenged
by the perpetrator. Reproduction
of editorial content of this journal is prohibited without publisher’s
permission.
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