Morphine detected on toxicology can be a breakdown product of heroin or can represent free morphine, a prescribed pain medication. Codeine is also an opioid pain medication and can be broken down into morphine. It is also found as a contaminant in heroin. When one sees codeine and morphine on toxicology it brings up the possibility of heroin, but does not confirm its presence. To confirm the presence of heroin, we look for 6-monoacetylmophine, also called 6- MAM. Sonny‟s sample size or the amount of Morphine and Codeine in his kidneys was insufficient to conduct a 6-MAM even today. Heroin shares the core structure of morphine, with the addition of 2 acetyl groups, which are thought to enhance its permeation into the central nervous system.(2,3) Heroin is metabolized by sequential removal of these acetyl groups; loss of the first acetyl converts heroin into 6-monoacetylmorphine (6-MAM).(2,3) Heroin is rarely found in meconium since only 0.1% of a dose is excreted unchanged. 6-MAM is a unique metabolite of heroin, and its presence is a definitive indication of heroin use. Like heroin, 6-MAM has a very short half-life; however, its detection time in meconium, the first fecal material passed by the neonate, is uncharacterized. 6-MAM is further metabolized into morphine, the dominant metabolite of heroin, and morphine will typically be found in a specimen containing 6-MAM.