I read entertainment news fairly compulsively, even reading about television shows I will never watch and movie stars I know I detest. In this case, I was reading a recent news report about a musician I never deliberately listened to in my life – Rick James, whose recent death is old news by now. When James first died, drugs were implicated in his death, due to his history as a crack cocaine addict. But the official autopsy results were delayed while a coroner’s pathologist did toxicology and other tests. These results were made public on September 16th. The official cause of death was determined to be heart failure due to an enlarged heart, with numerous drugs listed as contributing factors.
Numerous, in this case, being nine drugs. Here’s the laundry list from the coroner’s statement:
“Toxicology revealed the presence of the following drugs: Alprazolam (Xanax), Diazepam (Valium), Bupropion (Wellbutrin), Citalopram (Celexa), Hydrocodone (Vicodin), Digoxin, Chlorpheniramine, methamphetamine, and cocaine. None of the drugs or drug combinations were found to be at levels that were life threatening in and of themselves.” (Digoxin is a heart medication; Chlorpheniramine is an antihistamine, used to treat allergy and cold symptoms.)
What cracks me up about this (aside from the “meta” crack up of being cracked up about anyone’s death in the first place) is the way that David Campbell, the coroner’s spokesman, made it clear that, because none of the drugs or drug combinations were life threatening in and of themselves, “He didn’t die of a drug overdose.”
I guess I must have missed the clinical study where they gave rats all nine of these drugs and then carefully observed their hearts as they did not explode, thus proving that James could not have overdosed on the nine drugs within reach at the time. I can certainly think of a few cases at Burning Man where I got up in the seven drug range within a forty-eight hour period, but a) heart medication was not one of them, and b) heart medication was not one of them! It makes me wonder if rock stars should have to undergo a physical screening determining how fit they are for a future of drug abuse before we the music-consuming public agree to finance their careers – “You must be able to consume x substances at once and survive in order to ride this ride” or something similar.
I think what’s interesting here is the disparity between what the coroner considers a drug overdose and what a dilettante drug columnist considers a drug overdose. The Reuters article states that “the death was declared an accident”, and I suppose that’s technically true – James undoubtedly had reason to believe his heart would not explode, unless there’s a secret suicide note somewhere and a video of him meticulously polishing off every drug in the house. But how is this kind of “accident” not an overdose? Is the coroner’s spokesman honestly saying, “This man’s heart just accidentally exploded” as though his arteries, like, tripped on a curb or something? Is the coroner’s spokesman honestly suggesting that taking theoretically non-lethal amounts of nine different drugs at once is somehow an underdose?
At any rate, this got me wondering about other interesting celebrity overdoses that I might have overlooked. Did you know, for instance, that the author Honoré de Balzac is sometimes said to have died of a caffeine overdose from excessive coffee drinking? Some sources say it was stress or overwork that killed him, but we must put that in the context of writing sixteen hours a day for much of his life while fueled by, as Balzac described, “torrents of this black water.” At that point, you begin to wonder if history is playing the same kind of trick as with James’ coroner’s report. “It was not a caffeine overdose,” a spokesman for Balzac’s coroner might have claimed. “It was exhaustion from having had to raise the mug to his lips so many times. His muscles couldn’t keep up!”
Unfortunately, however, the vast majority of drug-related celebrity deaths are as mundane as the vast majority of completely unknown drug-related deaths. It’s all just “left the needle in my arm this” or “shot myself on Quaaludes” that. Oh sure, recently a man drove home drunk and wound up decapitating his drunken best friend, who’d had the misfortune of leaning out the passenger window in the presence of an oncoming telephone pole support wire. But in years to come, no one will remember this story, because the driver was not, for instance, Burt Reynolds, driving home with his unfortunate buddy Dom DeLuise. Had this horrible event occurred in Cannonball Run, say, you would have seen Burt screaming down the highway in some fancy Corvette, shouting, “Hey, Captain Chaos, hand me another Schlitz!” and then there’d be this loud FWACK! sound and Burt would be all, like, “C’mon, Captain, don’t tell me all we have left is Schlitz LITE!” and then, like, four states later, he’d get passed by Dean Martin holding Dom’s head out the window going, “Hey J.J., looks like he’s Captain CUT MY FRICKIN’ HEAD OFF now!” and there’d be all these blondes in the back seat giggling and stuff. That would be something people would remember.
It does seem fairly clear to me that, regardless of what the coroner’s spokesman had to say on the subject, the story of Rick James will likely be remembered as a drug overdose. If there’s some subtle medical distinction that the coroner’s spokesman was trying to make when he declared James’ death an “accident”, it’s a distinction that never had a chance of making it through the filter of the media, that vast factory of over-simplification and lurid hype. If James were alive today – well, if he were, he would likely be shouting “Help, I’ve been buried alive!”, but if he were alive and not buried and were able to provide counterpoint to the coroner’s spokesman, I bet even he would say, “No, that was definitely an overdose. I really shouldn’t have taken that last Celexa.”
But truly, the world will never know.
Just because he had traces of those drugs in his system, does not mean they directly caused an overdose. Xanax, Valium, Wellbutrin, Celexa…these drugs have long half lives, and were likely prescribed to him for psychiatric reasons. The same with his heart medication and antihistamine, but for medical reasons. They would be at low doses, meant for everyday use. So of course he had these in his system.
The rest appear to be recreational, but even then, we can’t assume that they were all still active in his system, merely present in trace amounts. You seem to think he popped all these at once, and then his heart EXPLODED. It failed, hearts fail all the time. The coroner obviously felt that the levels of drugs in his sytem AT THAT MOMENT, would not have killed a normal adult. That he had a pre-existing medical condition that may have been exacerbated by his drug use, but did not directly kill him.
Think of yourself, you find out you have a heart problem. You’re prescibed heart medication, Xanax for depression, Wellbutrin for depression, and Prozac, all at small doses. You smoke a joint in the morning, have a cigarette and a glass of wine in the evening, and your heart fails when you are sleeping. Boom! 7 drug overdose!!! Maybe you took a vicodin for back pain in the afternoon…8 drugs! Two days earlier you sniffed a bit of methamphetamine for an interview, 9 drugs! You sniffed a line of cocaine in the morning…10 drugs! They are still in your circulatory system for a while…detectable…but not necessarily having large effects.
Please be more rational.
When I think of myself finding out I have a heart problem, the first thing I do not do is smoke a joint in the morning, have a cigarette, or sniff methamphetamine for an interview. I think it’s perfectly reasonable to suggest that a man who has been prescribed multiple drugs for psychiatric reasons and multiple drugs for medical conditions (heart! problem!) has no business putting meth and coke into his body, and that even if absolutely all nine of those drugs were at trace levels in his system (un! likely!), reasonable laypeople could easily conclude that he’d still drugged himself to death. The issue is the word “overdose”, which certainly has a technical meaning to medical practitioners, but has multiple meanings to laypeople, and to suggest via press conference that “he did not overdose” will seem like a stretch if no additional effort is taken to quantify just how exactly he didn’t overdose.
As for me being more rational, I would be happy to, if that were something I had any actual control over.
Thanks for writing!
Nine (pharmaceutical) drugs. In one human circulatory system. In the combination stated above. Whatever the previous history – unless you have a very special physical and metabolic constitution, this is very likely to cause a little bit of a problem. Even if he didn’t down all of the substances at a time. Don’t get me wrong: I like Rick, I have a tendency to sympathize with that sort of “Superfreak” attitude. But I don’t think he did that combination for the first time on the day he died. His poor body was probably just a little too stressed in that situation and, even if he wasn’t keen on killing himself, suddenly decided to put an end to a life that was certainly full of memorable excesses. A person like Rick must have known how powerful certain substances can be, especially when combined in such a reckless manner. My view is: he was not in full control of his mental powers, and in the end turned out to be a little unlucky. I will always remember him as one of the craziest fuckers ever. Jah bless the Superfreak.
Peace
Its really just a simple question:
Over 4 dimensions, do you consider a “contributory factor” to be a “cause”?
Or to really streach this out, say you smoke crack every day for 10 years. Quit for 5 years. Then one morning you have a cup of coffee and go for a run. Pow, heart attack! Your first one!! Was it really the coffee?
Historical FYI: French King Louis the 14th lived to such excess, (eating, drinking, sex, and god knows what else) that his cause of death was simply ruled “Excessive Lifestyle”. Now thats a way to go out!!
The statistics prove that emergency room visits for legal drugs, as well as the deaths caused by them, taken according to the doctors guidelines, far outweigh all deaths do to drug ‘overdoses’ of illegal or illicitly obtained drugs. No one can say for certain, unless theories are thought about and tested, and repeated, that all the drugs in his system caused him to have a real ‘overdose’. We all want to look good when we die, it is just a natural inclination, people dont want to look like jerks, they want to be remembered in a good light. Since no studies have yet to be made about this particular combo, there is sufficient doubt that the amounts in his system, according to the Coroner anyway, that James death was as a result of an enlarged heart, and not an ‘overdose’. Hence, that is how he died, of a heart pproblem…
Personally, having in your system three types of depressent drugs, Valium, Xanax, and the Hydrocodone, and from a good source of drug info(rxlist.com)about Chlorpheniramine, it says: “This medicine may cause drowsiness. This medicine can add to the side effects of alcohol and other sedative medications. It is an antihistamine type of drug then. “And do not take this product if you are taking sedatives or tranquilizers without first consulting your physician.” Did he or didn’t he?
PLUS, being on three types of stimulants, one of which was Cocaine, (from Erowid.org) ” Can decrease seizure threshold and is associated with seizures, strokes, and heart attacks in susceptible individuals.” Wellbutrin has also been know to decrease seisure thresold too.
Methamphetamine, and Wellbutrin, and the other heart med, all present in his system at the same time, was probably not the best of ideas. We must remember that the first two stimulants listed, the Cocaine and Methamphetamine, are water-soluable drugs, and thus are eliminated from the body in 48-72 hours, at most, usually 24-48 hours is common. So he had to use those recently in order for then to show up on toxciology reports.
The Wellbutrin was probably taken as an antidepressent, and we don’t know how long James was on that. Probably a while, as it is a subtance with low recreational potential, I don’t hear of many people taking Wellbutrin for fun.
The family of drugs known as Benzodiapines are fat soluable drugs though, and can hang around for weeks after they are last used, so elimination of that class of drugs is slow. And no one really would know without a lab testing for the heart meds added to that all that, “None of the drugs or drug combinations were found to be at levels that were life threatening in and of themselves.” How does anyone know that? It has not been studied. Sounds like a true Overdose to me, the media is only trying to sweeten up the words, to make it sound nicer. He died of an enlarged heart after all, not a nasty, dirty, Overdose. At least that is all we will ever be told.
It’s recommended with Wellbutrin that you be “careful” with alcohol (according to some papers this translates as “don’t change what you are doing but don’t drink to excess” and in some it means you probably shouldn’t have more than a drink a day). The 4 page paper put out by Wellbutrin also states that studies were done with Wellbutrin and cocaine and that the combo can lower your threshhold for seizures and possibly cause other health problems that would not be caused by cocaine alone. I don’t know that it states in the paper how *much* cocaine.
So even if the toxicologists states that no one drug means “no overdose”, what is it called if the cumulative amount of drugs and drug combinations in your system should be considered an overdose? He had 3 depressants with 2 stimulants, Wellbutrin with cocaine (did he have alcohol in his system as well?), and digoxin with an OTC cold medicine (did he check with his doc first? digoxin is not supposed to be mixed with certain ones without checking but i can’t remember why…)
Wellbutrin combined with cocaine is definitely enough to kill someone. I have witnessed people feeling like they were dying from low-dose combos of just those two chemicals. I imagine the meth, the opiate, the Celexa, and the benzo’s didn’t help either.
RE: Louis XIV. Disregarding the STD issue (IE assuming your protection works), is it possible to die of too much ‘rutting’ alone? I’d’ve thought it was quite good for you……..
Free Coffee Samples…
I couldn’t understand some parts of this article, but it sounds interesting…