Another Poppy Tea Death

July 22, 2009

Damn. A Twitt from @abelpharmboy alerted me to this article in the Denver Post.

A 19-year-old man was found dead in Boulder on Tuesday morning, and authorities suspect poppy tea as the cause.
If so, it would be the second death in five months of a young person in Boulder who drank opium tea, police said.
Jeffrey Joseph Bohan, a 2008 graduate of Fairview High School in Boulder, drank the powerful psychoactive brew with his older brother about midnight, authorities said.
His brother found him unresponsive at 6 a.m. in a home

Abel Pharmboy had written some comments about that first death of a young man in Boulder. In the first post, Able overviewed a bit of the history of the medicinal (and recreational) preparation of products from the opium poppy.

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Here we go again. Celebrity dies at a slightly unusual age from an acute failure of essential bodily physiological competence and I’m thinking about drugs. My man @abelpharmboy sent me a note yesterday anticipating the same thing I did when learning of Michael Jackson’s heart attack and demise. [Update: Abel Pharmboy’s post on Demerol and cardiac arrest] Now of course our resident expert in the relevant physiological systems cautioned that I was perhaps jumping the gun. To which I confessed a hammer/nail orientation. Still.
Sure enough, at least one person close to MJ is railing about the drugs.

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Abel Pharmboy’s recent post remembering his father is evocative, emotional and an all around brilliant bit of writing. I can’t help but note, DearReader, that his post strikes me hard as a father and as a son. I think it had a similar effect on many of his readers. There is an additional component, though, in that it puts a personal face on the motivations of those of us who work on issues related to substance abuse. It isn’t a collection of incontrovertible data. No. It is a personal anecdote. But pain distributed is pain diffused. And the statistics loose much of their impact this way. This memorial of Abel’s though. This is concentrated. And for those of you lucky enough to never have a substance dependent individual in your lives, perhaps even this is not enough. For many of us, however, only a couple of stories like this are sufficient justification.

When I think back, though, I believe you died some eight years earlier, just after your 50th birthday party. For your wife, my Mom, it was even long before that – she is a saint for staying with you as long as she did – no offense, Dad – and I know she still loves you no matter what.
Our family runs rich with depression and alcoholism but you died exceptionally early; my Dad – the young, fit, handsome fella you were in those pictures with little me at the Jersey shore, at home, or with me in that horrible Easter outfit – had died back then and was replaced for the last eight, ten, fourteen years by someone else.

Go read the rest, this can wait.

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In a post on the death of Heath Ledger a year ago I talked about the frustration of not being able to review the toxicity panels from his body tissues after the autopsy. In the end, the medical examiner report just said something along the lines of “in my professional opinion it was the combination of drugs which did him in”. Which one might interpret as meaning the tox panels did not identify an apparently lethal level of any one particular drug (or its metabolites). But as an interested party, I would like to see the numbers. Because in my view they would reinforce the message. Whether it be a drug interaction or a loss of tolerance (or for that matter a tolerance issue) that is associated with a highly public drug toxicity case, it is an opportunity to help people to understand basic pharmacological concepts as they apply to recreational drug use. Another sad case is in the news this month and once again, the data would be exceptionally helpful.
An Australian woman died after allegedly taking two ecstasy tablets.

Neville and Gerry Bebendorf, both high school teachers, are left to mourn their eldest daughter, whom Mrs Bebendorf described as “a beautiful, fragile person who touched many hearts”.
“Rosie was cruelly treated by unscrupulous people who took advantage of her vulnerability and generosity,” she said.
“If any good is to come of this, it may serve as a warning to young people never to start taking drugs.”

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A recent post of Zuska’s discusses the pejorative use of “anecdote” to dismiss personal accounts of gender bias. The generic argument will be well familiar to many scientists who are used to sneering at sources of insight that are limited to individual data points. I concur in many cases however I also value anecdotal observations much in the way that commenter Sanguinity identified a number of useful applications of the anecdote in science including the following:

– suggest a new direction for query/research.

In that last case, the anecdote is a potential source for a vast new amount of information, but only if you don’t dismiss it out of hand as “just an anecdote.”

This reminded me of a post I wrote previously on the value of anecdotal case reports describing MDMA-related fatality and medical emergency.


The singular of data is “anecdote”.
We all know this hoary old scientific snark. Pure Pedantry ponders the utility of Case Reports following a discussion of same at The Scientist.
The Pure Pedantry Ponder identifies “rare neurological cases” as a primary validation for the Case Study, but the contribution goes way beyond this. Let’s take YHN’s favorite example, drug abuse science and MDMA in particular.

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A recent post of Zuska’s discusses the pejorative use of “anecdote” to dismiss personal accounts of gender bias. The generic argument will be well familiar to many scientists who are used to sneering at sources of insight that are limited to individual data points. I concur in many cases however I also value anecdotal observations much in the way that commenter Sanguinity identified a number of useful applications of the anecdote in science including the following:

– suggest a new direction for query/research.

In that last case, the anecdote is a potential source for a vast new amount of information, but only if you don’t dismiss it out of hand as “just an anecdote.”

This reminded me of a post I wrote previously on the value of anecdotal case reports describing MDMA-related fatality and medical emergency.


The singular of data is “anecdote”.
We all know this hoary old scientific snark. Pure Pedantry ponders the utility of Case Reports following a discussion of same at The Scientist.
The Pure Pedantry Ponder identifies “rare neurological cases” as a primary validation for the Case Study, but the contribution goes way beyond this. Let’s take YHN’s favorite example, drug abuse science and MDMA in particular.

Read the rest of this entry »

Members of San Diego State University are expressing an interesting attitude in the aftermath of the drug sweep which arrested 75 students of SDSU. According to the initial reporting it is clear that members of an organized drug marketing organization were targets.

One alleged dealer, Theta Chi member Kenneth Ciaccio, sent text messages to his “faithful customers” announcing that cocaine sales would be suspended over an upcoming weekend because he and his “associates” planned to be in Las Vegas, authorities said.
The same message posted “sale” prices on cocaine if transactions were completed before the dealers left San Diego.

It is equally clear that some individuals arrested were merely customers. Drug users, not dealers. Presumably this is why elements of SDSU are now questioning the appropriateness of calling in undercover federal agents on this case.

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Perennial Playboy Magazine Top-Ten Party School San Diego State University is in the news following the arrest of some of its students on allegations of illicit drug dealing and drug possession. The San Diego Union Tribune is reporting:

Federal agents and SDSU police culminated a yearlong investigation into drug dealing around campus yesterday, …Ninety-six suspects, including 75 SDSU students, have been arrested on drug-related charges…The SDSU Police Department approached the DEA and county narcotics task-force officials for assistance in December, when it became clear that the trafficking was more widespread than it could handle.
Investigation seizures by the numbers (sidebar; SOURCE: SD County District Attorney’s Office)

  • 50: Pounds of marijuana
  • 4: Pounds of cocaine
  • 3: Semiautomatic handguns
  • 1: Shotgun
  • 48: Marijuana plants
  • 350: Ecstasy pills
  • 30: Vials of hash oil
  • $60,000: Cash

Sadly, the investigation was sparked by a drug-overdose fatality, albeit of an anonymous undergraduate rather than someone as famous as Heath Ledger or Len Bias. There is also another drug-overdose fatality caught up in this story.
I want to talk about Jennifer Poliakoff and Kurt Baker today.

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In his classic song the great philosopher and student of addictive disorders, Hank Williams, Jr., blames a traditional source for increasing the probability of developing substance abuse:

….Hank why do you drink?
(Hank) why do you roll smoke?
Why must you live out the songs you wrote?
Stop and think it over
Try and put yourself in my unique position
If I get stoned and sing all night long
It’s a family tradition!

A piece in the New York Times covers a county in New Mexico which experiences some of the highest drug-overdose rates in the nation

recorded deaths have been steady, around 20 a year in a county of 41,000. Meanwhile, the health department trades about 12,000 clean syringes for used ones in the county each week.

The article attributes much of the blame to a familiar “Grim Tradition”.

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In his classic song the great philosopher and student of addictive disorders, Hank Williams, Jr., blames a traditional source for increasing the probability of developing substance abuse:

….Hank why do you drink?
(Hank) why do you roll smoke?
Why must you live out the songs you wrote?
Stop and think it over
Try and put yourself in my unique position
If I get stoned and sing all night long
It’s a family tradition!

A piece in the New York Times covers a county in New Mexico which experiences some of the highest drug-overdose rates in the nation

recorded deaths have been steady, around 20 a year in a county of 41,000. Meanwhile, the health department trades about 12,000 clean syringes for used ones in the county each week.

The article attributes much of the blame to a familiar “Grim Tradition”.

Read the rest of this entry »

I’m following up on some blogging resulting from a recent post of mine on the effect Len Bias’ death (apparently) had on population level perception of the riskiness of trying cocaine. This will verge on the type of link-vomitus that is much despised by the PhysioProf, so consider yourself warned!

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I have a tendency to refer to data from the Monitoring the Future study with some frequency. Unfortunately I’ve been too lazy to post the critical data figures for your entertainment. Until today DearReader.
One example of which I am particularly fond, is what I call the “Len Bias effect” on the public perception of “risk” associated with casual use of cocaine. I refer to this so often because of the casual sneering response I (and others of my approximate generation) retain for the “Just Say No” program championed by Nancy Reagan in the mid-80s. The MtF data suggest to me at any rate that our “gut feeling” that these types of programs are stupid should be more nuanced.

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As a follow to my prior comments pointing out that the press reports on Heath Ledger’s death were unnecessarily devoid of neuropharmacological perspective, I’ll note that the report on the drugs found in Heath Ledger’s body after his death is now out. Abel Pharmboy has the call:

this report is just in from AP on Heath Ledger’s toxicology report:

The cause of death was “acute intoxication by the combined effects of oxycodone, hydrocodone, diazepam, temazepam, alprazolam and doxylamine,” spokeswoman Ellen Borakove said in a statement.

The opiates oxycodone (OxyContinTM) and hydrocodone (VicodinTM and a host of other products) did not appear, to my knowledge, in the news that leaked out in the days following Ledger’s death. This is an interesting twist.

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As a follow to my prior comments pointing out that the press reports on Heath Ledger’s death were unnecessarily devoid of neuropharmacological perspective, I’ll note that the report on the drugs found in Heath Ledger’s body after his death is now out. Abel Pharmboy has the call:

this report is just in from AP on Heath Ledger’s toxicology report:

The cause of death was “acute intoxication by the combined effects of oxycodone, hydrocodone, diazepam, temazepam, alprazolam and doxylamine,” spokeswoman Ellen Borakove said in a statement.

The opiates oxycodone (OxyContinTM) and hydrocodone (VicodinTM and a host of other products) did not appear, to my knowledge, in the news that leaked out in the days following Ledger’s death. This is an interesting twist.

Read the rest of this entry »

I missed this story at National Public Radio initially but luckily multiple sources have been all over it, see below. The nutshell from the NPR piece on a Cambridge, MA heroin-addict treatment center is as follows:

Elissa has been on methadone for six years, but she confesses that she used heroin a couple of days in the previous month because she was under a lot of stress.
Like most long-term heroin users, Elissa has had scary experiences with overdoses – her own and others’. Once, her partner became unresponsive after taking a mixture of heroin, benzodiazepine pills and alcohol, she says.

“Where to start, where to start?”, muses Your Humble Narrator. Where indeed. From the start we have the concepts of agonist therapy for drug abuse, the generally poor performance of interventions for drug abuse at present, relapse, overdose in users, whether in treatment or not, and drug combinations resulting in medical emergency. Are you getting the impression this stuff is complicated? Good. Because people in the Office of National Drug Control Policy (aka “Drug Czar”) seem to think this is duck soup. Even when they should know better.

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