Controversial DXM death case

[rfgdxm]

Just found out about this from my website log referrals, of all places. I
refer to this:

http://www.projectghb.org/prescription_drug.htm

Carl Hennon
Age 18

I Sit Here Thinking
by his mother, Misty Fetko

I sit here thinking: "Where do I begin?" My son is dead. He was only 18
years old. Despite the pain those words represent, I know that I must write
this letter to share with his friends, classmates, parents and teachers, the
horrible lessons of his passing. When Carl Hennon passed away on July 16,
2003, my whole world crashed in on me. "What happened?" was all that kept
racing through my mind.

In the days since his death, I have discovered many things that have shocked
me. It hasn't been that long since I was 18. I remember what it was like. I
listened to Carl. I talked with him every day, about everything - or so I
thought. I asked the right questions - or so I thought. For all the things
that Carl had shared with me, he had a secret that would ultimately prove
fatal.

Carl had discovered through the aid of the internet and through his friends,
the powerful, psychedelic properties of Robitussin; a legal,
over-the-counter, cough suppressant. Carl died from a fatal combination, an
accidental overdose; of Robitussin and a prescription narcotic taken while
"Robotripping". It was not suicide.

Why Robitussin? Because it contains dextromethorphan, or DXM, which in high
doses act as a "dissociative anesthetic" much like ketamine or PCP. Many
websites are providing information on these "designer drugs;" how to use
them, what other drugs to use them with, how to group "trip," etc. Why was
Carl using these drugs? Why did we have to find out by reading his autopsy?
We will never know, but certainly he thought that he had found a legal,
affordable, and safe alternative ? all supported by information available on
numerous websites.

Why weren't there any signs? I was looking for the illegal, street drugs,
but this wasn't my nemesis. My nemesis was actually sitting on a drugstore
shelf, or in a medicine cabinet; secretively, legally, and affordably.

Information is powerful; I only wished that I had had this information
before Carl passed away, and then maybe I could have helped him more. There
is no safe "trip". There are no controls or guarantees. It doesn't matter
that you are 18, healthy and smart. It can happen to you. It happened to
Carl. My only hope is to reach out and inform. If I can touch at least one
life, then I know that someone else will not being saying their final
goodbyes to their sweet child, and then sitting down with pen in hand,
wondering where to begin. My son is dead. He was only 18 years old.

-----

Begin rfgdxm comments:

I have in my possession the actual coroner's report for the death of Carl
Hennon. It list that fentanyl (an opioid) was found at toxic levels, and
levorphanol (another opioid) was found at therapeutic level.
Dextromethorphan was also found, but at therapeutic levels. Trace amounts
of other drugs, like caffeine, nicotine, and cannabinoids were also found. I
actually spoke with the coroner to confirm that the DXM levels found were
indeed in the therapeutic range. "Therapeutic" levels here mean consistent
with taking in amounts recommended on the bottle.

According to the source that tipped me off about this case, Carl was a
DXM (ab)user. However, according to the coroner's report, calling this a
death involving DXM is about as accurate as calling this an overdose involving marijuana. From what my source indicated, empty bottles of
Robitussin, and also Dramamine, were found in his home. My best guess is
that the DXM found in the autopsy was from recreational use days ago.
However, that isn't what killed him according to the coroner. It was instead fentanyl.

I didn't report this previously because the DXM use didn't appear
material to the death. And, I was concerned about family privacy. (My source
wasn't a family member.) The death notice in the paper said "natural causes"
in the paper according to my source to protect family dignity. However, now
that the family has gone public, things seem to be different.

More comments later.

Ask the coronor if you can quote him. Inform the family that they are being totally misleading.

EDIT - oh yes, and I couldn't find a contact address on that website but if I were you I would e-mail those in charge of the websites to let them know that their story is misleading.

My suspicion is that they won't care.

[rfgdxm]

I've got the coroner's report next to me right now. It is public record.

"A Comprehensive Analysis In Blood Has Been Performed.

"The Following Agents Were Detected:

(Only relevant ones listed)

"X Fentanyl 2.74 ng/ml Blood

"T Levorphanol Trace Blood
"T Dextromethorphan 14.0 ug% Blood

...

"T: Amounts Present Are Consistent With Therapeutic Levels
X: Amounts Present Are Consistent With Toxic Levels"
----

The amount of DXM is listed as a normal therapeutic level, and when I asked the coroner he indeed said this was so according to a medical text about tox levels for DXM. The immediate cause of death is listed as:

"Drug (fentanyl, levorphanol, dextromethorphan)"

However, that is just because all are CNS depressants. Levorphanol was found at unmeasurably low levels, hence just listed as "trace". That toxic level of fentanyl is more than adequate to explain this death. If I put this up on my website as a DXM death, then I should be also listing any heroin overdose death where slight amounts of DXM were detected becuase the heroin addict took some OTC medicine with DXM added to clear up the sniffles from a cold. I say the spotlight in this death should be on the fentanyl, and not the ordinary amounts of DXM consistent with using as directed on the package found in his system.

I agree with you.

[Dexation]

Originally posted by rfgdxm@Mar 25 2004, 11:09 PM
"X Fentanyl 2.74 ng/ml Blood

"T Levorphanol Trace Blood
"T Dextromethorphan 14.0 ug% Blood

...

"T: Amounts Present Are Consistent With Therapeutic Levels
X: Amounts Present Are Consistent With Toxic Levels"
----

The amount of DXM is listed as a normal therapeutic level, and when I asked the coroner he indeed said this was so according to a medical text about tox levels for DXM. The immediate cause of death is listed as:

"Drug (fentanyl, levorphanol, dextromethorphan)"

Here is another problem. The coroner's report is a public record. It shows T Dextromethorphan 14.0 ug% Blood. Even though there is a footnote about T being amounts consistent with therapeutic levels, and the Fentanyl was present in toxic levels, there is still no comparison or indication as to what ranges those levels actually are for the public to view.
Not all of the public who view this report will no what "T Dextromethorphan 14.0 ug% Blood" means or have the means to figure it out. Some will not even really know what therapeutic levels are.
With something to use as a comparison for these doses, the relatives and friends of the deceased will have a better idea of what the actual cause of death had been.
Thank you for the information
Dexation

[boulderguitarist]

Originally posted by KILLBILL@Mar 25 2004, 10:42 PM
Ask the coronor if you can quote him. Inform the family that they are being totally misleading.

EDIT - oh yes, and I couldn't find a contact address on that website but if I were you I would e-mail those in charge of the websites to let them know that their story is misleading.

My suspicion is that they won't care.

I found the contact adress, and i to would write a letter, but i don't have an email adress while on im on vacation, post it in this thread or PM me and let me know how they reply or if they even dignify you with an answer

http://www.projectghb.org/contact.htm

[rfgdxm]

Originally posted by Dexation@Mar 26 2004, 12:20 AM
With something to use as a comparison for these doses, the relatives and friends of the deceased will have a better idea of what the actual cause of death had been.

No. Read that link I gave above.

"I asked the right questions – or so I thought. For all the things that Carl had shared with me, he had a secret that would ultimately prove fatal."

"Why weren’t there any signs? I was looking for the illegal, street drugs, but this wasn’t my nemesis. My nemesis was actually sitting on a drugstore shelf, or in a medicine cabinet; secretively, legally, and affordably."

That's what his mother wrote. According to her, not only was she oblivious to her son's DXM use, before he died she didn't have a clue that OTC cough medicines could be used recreationally. She writes that she found this out only after researching it on the Internet after his death. She knew nothing of the amounts of DXM that her son was taking. From a source close to the family I was in contact with, only after he was dead, and Robo bottles were found in his room, did the family become aware of his DXM use. Those Robo bottles consumed could have been taken hours before his death, but also may have been taken days or weeks before his demise.

As such, the only source of relevance is the coroner. One open possibility is the coroner may not have interpreted the data correctly. I'm looking into this possibility in fact at this moment. I've got the full post-mortem tox results. Looking at them again, I have some doubts, and will need to have these interpreted by people with the expertise to do so. The problem here will be that with the coroner stating that the DXM levels were at ordinary, therapeutic amounts, imagine the political implications if I were to question these publicly on a high visibility website. The problem I have is the mother is publicly calling this a DXM death on the Internet. I can't just ignore that. Basically, I'll have to take some position. Either the coroner, his mother, or both won't like what I have to say.

[rfgdxm]

Originally posted by MindDexPlorer@Mar 26 2004, 12:38 AM
I found the contact adress, and i to would write a letter, but i don't have an email adress while on im on vacation, post it in this thread or PM me and let me know how they reply or if they even dignify you with an answer

http://www.projectghb.org/contact.htm

I'd suggest you wait until I sort all this out with scientifically credible sources. It's possible that based on the data I may conclude it looks like a fentanyl + DXM OD death, and both were material. If so, then that projectghb.com site may have it half right. The problem is that while that site states "Carl died from a fatal combination, an accidental overdose; of Robitussin and a prescription narcotic taken while “Robotripping”.", basically it totally glosses over all that fentanyl in his system (fentanyl isn't mentioned by name even), and focuses on DXM. If the fentanyl alone would have been a fatal dose, this is highly material. Basically, from the autopsy results this kid may have been a serious polydrug abuser. Anticholinergics were also found in his system too.

[libel]

The problem is that while that site states "Carl died from a fatal combination, an accidental overdose; of Robitussin and a prescription narcotic taken while “Robotripping”.", basically it totally glosses over all that fentanyl in his system (fentanyl isn't mentioned by name even), and focuses on DXM. If the fentanyl alone would have been a fatal dose, this is highly material. Basically, from the autopsy results this kid may have been a serious polydrug abuser. Anticholinergics were also found in his system too.

Exactly. Terms can be very misleading in varied contexts.

I suggest you e-mail or talk to a toxicologist who is willing to spend a few minitues looking over the results or find an article about DXM metabolism and concentration of it and its metabolites in the blood. See if the reported value for Mr. Hennon is consistent with the literature values.

I wouldn't write anything myself that made any assertions that I did not feel were justified.