Friday, January 02, 2009

Drugs can kill you even when "sober"

I read an interesting study/article the other day (it was recently sent as a pdf, so no link). Sure it doesn’t have the general appeal of the movie “Bedtime Stories” that I went to yesterday, but it brings up an interesting point for the Coroner Biz.

The conclusion of the study was that:
“Decedents with a history of chronic drug abuse appear to be at an increased risk of dying by their chronic drug abuse, even in the absence of any anatomical or toxicological finding at autopsy…” [Arch Pathol Lab Med, vol 132, Dec 2008, 1903-1906]

This really is contrary to what has been commonly thought; that drugs really only kill when they are at elevated levels in the body and sober deaths are not really related to the drugs.

Their original hypothesis was that “drug abuse induces some change that persists after the drug is no longer detectable in the body…presumably at the molecular level…increase(s) the likelihood of sudden death”. (This molecular level of effect brings to mind William Burroughs’ saying in “Junkie” that the junk gets into your cells with use, causing addiction, and has an effect basically forever.)

The study did find this effect in a broad range of drugs of abuse, some that you would suspect, but also others that might seem a bit of a surprise. The drugs included cocaine, amphetamines, opiates, other pain meds, benzodiazepines, and barbiturates.

The authors relate this increased risk of sudden death with chronic drug abuse to the already recognized similar occurrence with chronic alcohol abuse.

So, yet another reason to not abuse drugs: an increased risk of suddenly dying, even if not acutely intoxicated at the time of death. That should give folks pause and new meaning to a phrase I have used a time or two: “Drugs, they can make you high, they can make you die”.


Anonymous said...

My cousin died in his sleep and the autopsy said It was from something he took 2 days prior reacted badly with something else he took. He had a bad headache at the time so I know he did take ibuprofin and the report did not say what drugs interacted with what. I am wondering what drug can slowly kill you like that?

Dr. Richard Keller said...

Not much really comes to mind, particularly if he was well in the interim.

Things like ethylene glycol (antifreeze) and methanol can kill after a couple of days, but you are sick over the time that you are dying.

Demand more information.