Hydromorphone-Related Fatalities in Ontario
Bibliographic record
Abstract
The interpretation of drug intoxication in death investigations is based on the available published literature. In the case of hydromorphone, the literature is limited. This report serves to facilitate the evaluation of cases where hydromorphone may be implicated in a fatality through the examination of 251 hydromorphone-positive cases in the province of Ontario from 1985 to 2003. Thirty-three of these cases were selected for review in greater detail. In four cases in which hydromorphone was the sole drug detected and death was attributed to hydromorphone toxicity, concentrations ranged from 77 to 2684 ng/mL. Hydromorphone concentrations ranged from 21 to 441 ng/mL in 28 cases in which at least one other drug was detected. In five deaths attributed to natural causes, blood hydromorphone concentrations ranged from 75 to 423 ng/mL. The results of this study emphasize the importance of case specific information. Fatalities due to hydromorphone occurred at 51 ng/mL and greater; however, tolerant users of this drug, as seen in the deaths attributed to natural causes, may achieve incidental concentrations that would otherwise be considered fatal. Hydromorphone was detected and quantitated using gas chromatography-mass spectrometry.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".