Sidebar:

Another Case from an Incompetent Coroner

A significant part of the government’s strategy to demonize GHB has been to encourage reporters and coroners to allege GHB as a cause of death. This started with River Phoenix’s death at a Los Angeles nightclub (which also spawned the media’s false attribution “grievous bodily harm” to GHB). Unfortunately for the feds, River Phoenix had not cooperated, and the death had to be blamed on other substances. Fortunately for the feds, a naive coroner in La Porte, Texas took the DEA’s baited hook (with line and sinker), and Hillory Farias became the government’s poster child for the criminalization of GHB. The true circumstance of the Farias death has been covered previously in SDN v5n7p1 and SLN v7n1p1).

In the early days, it was possible for Dr. Ward Dean to investigate most of the allegations of GHB-induced death. But as the government’s strategy of withholding forensic information about GHB has mushroomed into 60-80 such reports (according to the FDA), Dr. Dean has been able to cover only a small fraction of those cases. The following case involves a death by water intoxication that was blamed on GHB by an incompetent medical examiner (i.e., coroner). Here is Dr. Dean’s report:

“The autopsy report showed that the individual was brought in to the emergency room unconscious, with a sodium of 107 (which the admitting physician reported as incompatible with life — normal levels are 130-145. The history was that this long-time alcoholic and drug abuser had gone clean. However, within several months of discontinuing his other drugs, he began to feel badly, and occasionally became disoriented. His sleep was very poor, and he began to drink lots of water. He then began to take GBL (gamma-butyrolactone) to help himself sleep. It would help for a while, and it made him feel better. However, he became progressively worse, ultimately lapsing into a coma, and was taken to the hospital. Based on this history, the County Medical Examiner (Placer County, California) made the diagnosis ‘hypoxic encephalopathy due to acute GHB toxicity.’ However, there were no laboratory reports with the autopsy (labwork was ‘pending’ at the time of coroner’s determination). I finally received the ‘missing’ lab report which revealed a blood GHB level of 12.5 mg/L. This amount of GHB is well within the range of 0-50 mg/L that is normally produced by the body after death. There was no GHB in the urine. The fact that there was no GHB in the urine proves conclusively that the decedent had not taken any GHB prior to lapsing into the coma. The coma was due to low sodium, and had nothing to do with GHB. It is clear that the cause of death was a previously undiagnosed case of a disease known as diabetes insipidus, which causes excessive urination. This resulted in thirst and subsequent water intoxication, which ‘washed’ the sodium out of his body (causing profound hyponatremia, or low blood sodium), which caused his death. His previous consumption of GBL in no way contributed to this death. The clinical presentation is certainly not consistent with a GBL/GHB overdose, and there is absolutely nothing in the scientific literature that would indicate that chronic use of GHB or its precursors would cause diabetes insipidus or hyponatremia. In this case, the cause of death was overconsumption of water.”

This case is the 12th Dr. Dean has reviewed. Of those twelve deaths, none were caused by any toxicity of GHB. They were either caused by pre-existing medical conditions (cirhosis), other drugs, or traffic accidents. One case that can be correctly related to GHB was a hypothermia case, in which a young man chug-a-lugged from a bottle of GHB (after being warned to consume only 1/2 capfull), and fell asleep unnoticed at a party in the desert. That night, the temperatures dropped to 37 degrees. This case involves taking GHB in an unsafe environment (where going to sleep could be dangerous), which we (and others) warn against. This hypothermia danger applies equally to the consumption of ethanol (alcoholic beverages or spirits). ——SWF