The drugs in his system weren't all that severe. First off, the butalbital is the barbiturate they mention. Used in Fioricet or Fiorinal for headaches. Barbiturates are much more dangerous than benzodiazepines and the reason barbiturates like phenobarbital are rarely used anymore for outpatients. Benzodiazepines are relatively safe with a high LD50 and low mortality rate. Of course, the barbiturates actually negate the effects of benzodiazepines in the CNS mostly because they both open the same chloride channel, however, GABA isn't needed to force it open with a barbiturate, whereas benzodiazepines rely on GABA levels to produce an affect.
And the pseudo is OTC decongestant. Big deal. I really doubt the levels of this stuff were at play. 4 mg of Ativan is nothing.
One must remember that the practice of toxicology is difficult. These results came pretty fast. When someone is obtunded then aspirating and unconscious, they become more and more hypotensive. The drugs will continue to metabolize and produce a lower level than what is suspected. Nevertheless, it appears to me, that he wasn't deceased if the Narcan was found in tissue. He was still perfusing blood. Many tissue sites are used for testing, and you won't have levels of a drug in your body if you weren't pumping blood to push it around your system.
And the pseudo is OTC decongestant. Big deal. I really doubt the levels of this stuff were at play. 4 mg of Ativan is nothing.
One must remember that the practice of toxicology is difficult. These results came pretty fast. When someone is obtunded then aspirating and unconscious, they become more and more hypotensive. The drugs will continue to metabolize and produce a lower level than what is suspected. Nevertheless, it appears to me, that he wasn't deceased if the Narcan was found in tissue. He was still perfusing blood. Many tissue sites are used for testing, and you won't have levels of a drug in your body if you weren't pumping blood to push it around your system.
