Wednesday, February 11, 2009

a blast from the past

My most comment attracting post: Cocaine and Death

I promise more new ones are on the way.


Anonymous said...

Hello, I came upon your blog from 2006 and it happened to hold a lot of information, but not enough to answer my question. I am from Texas, and hoped you could answer a couple questions for me relating to my brother's death from acute cocaine toxicity. The autopsy report states the manner of death was an accident. Knowing my brother and his past, I still believe that it was a suicide. Here are the levels of analytes that were found in his (femoral) blood specimen: Benzoylecgonine > 2.5 mg/L; Cocaethylene .005 mg/L; Cocaine > 0.5 mg/L

There were no other drugs found in his system. He was drinking beer and smoking crack at the same time and from the research that I did, I am aware that the two combined has a greater chance of death occuring, as in my brother's case. My mom found him dead, face down on the couch (lower extremities on the floor, feet slightly twisted and upper extremeties on the couch). She was shocked to say the least and when he didn't answer her, she went to turn him around and to horror saw his face, completely contorted. I was there and thankfully didn't see his face. My question is this, did he actually die from a heart attack or stroke from the drug or did he have a possible seizure, convulsions, etc.? A brief run down of the microscopic exam: heart x3 - normal myocardium; lung x 4 - lung parenchyma with early putrefactive chgs and slight increase in intraalveolar macrophages; liver x2 - liver parenchyma w/ early putrefactive chgs. and slight fibrosis around portal tracts; kidney x2 - kidney parenchyma w/ early putrefactive chgs. & vascular congestion; adrenal x 1 - normal adrenal cortex & medulla tissue, with intraadrenal lipoma.

I do not know the signs of heart attack or seizure...I just know that I need to know for myself, if he was in pain at time of death. I feel like he did so much to escape his life. He's been doing this stuff on and off throughout his life and knew the level that he could get away with without it being fatal; thus my feeling of him having the suicidal tendencies. I know he his self esteem was so low and things were not going well for him and he went downhill fast. Without going in to detail, his life, to him, had no meaning and he was more of a burden than anything else. However, this is not the case for his family -- this is his own self pride and his own doubt that he concluded. I feel he needed to escape it and this is how he did ingesting too much of the drug. I found, what appeared to be the drug he was smoking, in a yellow, sticky, rectangular block form and smelled like ether. I assume that is what it was.

I am sorry for the lengthy story, but I wanted you to have a little history of my brother and the autopsy report.

Kindest regards.

Dr. Richard Keller said...

Death from cocaine use most often comes at the hands of heart attack with abnormal rhythm, stroke or seizure, so any of these could have occurred (and heart rhythm problems are often accompanied with seizure-like activity).

Folks who abuse or overuse drugs are often self-medicating psyche problems and it can be a fine line between accidental overdose and intentional overdose. Also, folks who use cocaine (crack or similarly rendered compound as in this case) will very often use, in a given episode, until they ‘run out' or die.