Opioids Pls help!Brother died due to Mixed Drug Toxicity-Hydromorphone,Benzos and Mirtazapine

[styles82]

I hope I'm posting this in the right place as I wasn't sure where to post.

Hi all, I lost my 25 year old brother recently and I received the medical examiner's report today which lists the cause of death as 'Mixed Drug Toxicity'. He died in his sleep and was already gone for a couple of hours before we found him, while we waited for the ambulance we tried CPR with it was already too late... We were told later he was gone for at least a couple of hours before.

Losing him has been devastating and I'm trying to make sense of what happened. I know he had used oxy and cocaine at times and used Valium, Clonazepam and xanax often. He used to tell me he was quite careful about researching what to take and amounts and what not to mix etc. I found 2 Hydromorphone capsules in his room (red 30mg) and looking through his texts I know he met up with a friend two days before his death and got at least 3 of those from him so he took at least one that I know off 48 hours before he died. From their texts it sounded to me this was his first time using hyros but I know he used oxycontin whenever he could get it.

I have been researching blood test levels I received on the report and some of it does not make sense to me. There is mix of Hydro and Benzos and his antidepressant but other than the Hydromorphone the other levels are normal. I think Hydro level is toxic but not listed as lethal when I look it up. From what I'm reading on the web and this form I get that mixing all these drugs is dangerous but the levels other everything else looks normal and therapeutic.

He was put on Mirtazapine due to reoccurring depression (Had more troubles sleeping and no appetite). He was on Mirtazapine for 6 weeks before he died and this test just lists small amount of that drug and apparently was not sough to list. I just wonder how accurate this test is just because of that result since His doctor told me he increased his does a week before he died. I don't want to be in denial but I want to make sure cause of death is correct.

Here are his levels and what was found in his system.

EDIT: I'm pretty sure the Hydromorphone 30 MG and Xanax were taken at 48 hours before his death and not at the same time as the other drugs listed here.

Hydromorphone(unconjugated) 0.01 mg/l
Hydromorphone (Total) 0.06 mg/l

Alprazolam (Xanax) 11.7 ug/L = 0.0117 mg/l
Clonazepam 6.4/ug/l = 0.0064 mg/l
AminoClonazepam 65.2 ug/L = 0.652 mg/l
Diazepam (Valium) = small amount
Mirtazapine = small amount

Thank you. I appreciate you taking the time to read this.
Amanda

 

[cj]

Mixing benzos and opiates is dangerous business. I am not a toxicologist but I would guess he died from breathing depression from mixing benzos and opiates.

 

[exlolita]

I'm sorry about your brother. I can't answer your question about the specific toxicity levels but I will tell you that i mixed alprazolam, clonazepam, and hydromorphone orally and combined with alcohol which seems like a more dangerous combination, but if your brother insuflated the pills then it could have led to an overdose.
though I will say mirtazapine isn't the SAFEST anti-depressant out there, compared to like sertraline and although you can't really overdose on it, it is known for severely increasing drowsiness and that is why it is not widely prescribed, and since all of the other drugs also increase drowsiness, it can't be a good combination.

 

[Joey24x18]

Combining any benzo and opiate is dangerous business. What would regularly be a normal dose of one or the other can easily be lethal when combined. Same goes for any other CNS depressants. Sorry for your loss, losing a loved one is never easy.

 

[tacodude]

He also had xanax and another benzo.... 36 mg oral even ER is too much for one not tollerant to morphine like effects that depres the respitory system vs codeine type effects that aren't as heavy due to them having activity at two seperate opiate points, which seems to be a piece of information that needs to be more commonly understood. He took way too much hydromorphone especially when mixing benzos like he did. I dont understand the nunbers, but the combo explains it.

I hope that recovery for you isn't too hard. Death is devistating especially when so close and I nor anyone else here will understand how you feel now no matter how many people in our lives passed nor how recent. Just remember he lives on in your heart always so make sure you live for him as well as he will be watching you from the sky as a blazung beautiful star.

Please post back here if you need any support. If you ask a staff member to move this to the dark side section as this topic would fit there very wll getting more responses than here as well as sympathetic and empathetic responses.

 

[Mad Dash]

I am so sorry my friend... I have a younger brother and I just do not know what I would do. Unfortunately if his opiate dose was that high then having even a small amount of benzo in his body could have done the trick. But mitrazapine while not being a medication that you can abuse, is often used as a sleeping pill. So you combine all those and what happens is something called respiratory depression. This is essentially when you go into such a deep sleep that your body "forgets" to breath and you essential suffocate. But it is an entirely painless way to go... I don't know if that is much comfort but it is probably the most humane way for a person to pass away.

I would like to take a moment to point out to those of you that are riding the edge with your useage by injecting ambien and heroin, or injecting wellbutrin, or using so much heroin you can not even feel the euphoria from it anymore... This is how easy it is, you have not been getting away with it for so long because you are skilled at what you do. You have gotten away with it so far because of pure dumb luck. Treasure you lives and to OP I am so sorry for your loss. God bless you and your family and I will say a prayer for yall.

 

[dez79]

Morphine n benzos were the culprits low dose mirtazapine ain't gonna do much even combined. RIP to your brother sorry to hear and hopefully this saves a life on this site

 

[styles82]

Thank you all so much for your responses and support. It really helped me to understand it better since I have no experience with it myself. It still doesn't seem real that he is gone forever...

Yes sounds like this was all due to the combination of all the drugs even though they were at normal levels except the hyrdrmorphone. They all added up together. He took the hyrdrmorphone 48 hours however before his death which cause him to have the hiccups on a and off till before he went to sleep. I thought by then the effects would have worned off or lessened. Can hyrdrmorphone last that long in the system and interact with the other drugs? I thought only 12 hours? According to google the red 30 MG hyrdrmorphone he took is extended release.

Thanks, Amanda

 

[R3hab]

Sorry for your loss Amanda.

Yes as the others have said combining opiates and benzos can be extremely dangerous, simply too much respiratory depression.
Fall asleep and never wake up type thing, I know this is a very hard time for you and your family but remember that he passed away peacefully.
This forum is based on Harm Reduction because we realize that we can't stop people from doing drugs but we can educate people so they know the risks and benefits of their actions.
Even mitrazapine can have synergistic effects when combined with other drugs.
Bottom line: I would say it was the cocktail of drugs that when mixed together can be extremely dangerous

 

[tacodude]

There is no way he dosed the hydromorphone 48 hour before. There is a mistake somewhere. ER usually sustain the peak amount of medication for 50% the IR dose causing 15 mg IR oral dose peak to push ten hours until the pill runs out. It just makes no sense to be 48 hours.... Most likely 12 with him falling asleep peacefully after four six hourss. Just know he most likely gently passed thinking he wa just going to sleep.