Nearly every identity group employs a watchdog to defend its interests when the press stoops to filling news stories about its members with misinformation and stupidity. Gays have the HRC, Jews have the ADL, gun owners the NRA, and laboratory animals PETA. Alas, no group speaks on the behalf of America's dopers when journalists shovel manure and half-truths into print, so until such a group forms, I'll have to serve as their proxy.
In the last week, six people in Lower Manhattan have died in what appear to be heroin-related incidents. The New York dailies have swarmed the story—especially the deaths of Maria Pesantez and Mellie Carballo, two 18-year-old coeds.
Based on their sources in the police department, the medical examiner's office, and elsewhere, the dailies are speculating about a "bad batch of heroin" ( Daily News), "a batch of tainted heroin" ( New York Sun), "the same bad batch of heroin" that killed the other four users (Associated Press), "a poison or … [drugs] so pure and strong as to be lethal" (New York Times), "a $20 bag of bad cocaine and possibly heroin" ( New York Post), and "uncut heroin or cocaine" ( Newsday) rampaging through the town.
It could be that bad, tainted, poisoned, pure, or uncut heroin or cocaine killed Pesantez and Carballo, as well as the other four (Christopher Korkowski, Ivan Rivera, Anatoli Filistovic, and Charles Sicker). But I doubt it. A more plausible explanation for Pesantez and Carballo's deaths—multiple drug use—is as close as a search of the PubMed database of science journals.
To begin with, it's possible to inject a life-stopping quantity of heroin. Yet a 1996 review of the scientific literature published in Addiction states that, "In a substantial proportion of cases, blood morphine levels alone"—the body converts heroin into morphine—"cannot account for the fatal outcome of a heroin 'overdose.' " Authors Shane Darke and Deborah Zador continue:
It appears that a great many "overdoses" are in fact fatalities due to multiple drug use. Furthermore, many cases of apparent heroin overdose have either blood levels at the low end of the range, or at levels no higher than for survivors of "overdose" or heroin dependent users who die of other causes.
Likewise, toxic contaminants added to heroin can play a role in heroin-related death. But how often? The Addiction paper calls the role of heroin impurities "relatively minor, and possibly subject to regional variation."
Studies of heroin-related death support the multiple-drug-use theory. Morphine usually has company when autopsies test for drugs. In only a minority of such cases is morphine the only drug detected. And, depending on the study, alcohol was one of the other drugs detected in 29 percent to 79 percent of autopsies. In cases testing positive for alcohol, the blood-morphine levels were "significantly lower" than the morphine-only cases, according to a 1996 study. Benzodiazepines, the drug family to which Valium belongs, are "frequently noted at autopsy," states Addiction. Benzodiazepines are central-nervous-system depressants, like heroin and alcohol, and it's well known that mixing these drugs can lead to coma or death.
The authors conclude:
In many, perhaps the majority, of cases, it may be that heroin is no more than a contributory cause of death. … For a substantial number of heroin-related fatalities, then, heroin "overdose" may be a misnomer. To attribute the cause of these deaths to "heroin overdose" ignores the likely causal contribution of other drugs to the mechanism of death.
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