[hermantheshocker]

Germany. A 49-year-old deceased male, with a past medical history of substance abuse, was found by a friend after his separated wife could not reach him on his mobile phone. The friend, who had a key to the apartment, found the body prone on the bed in the bedroom covered in a sheet. The friend notified the wife and she called an ambulance. During the first postmortem examination, the emergency doctor noted suspected stab wounds on the man’s back and the police were notified.

An examination of the deceased’s room found a toppled glass on the bedside table containing a dried, white, crystalline substance. Traces of a similar substance were found on the wall and on the floor. On a shelf in the living room, two plastic bags were found containing a large number of white tablets with the imprint XANAX. In an adjoining room, there was a cannabis crop and smoking paraphernalia. The wife reported that her husband suffered from a fungal infection of the maxillary and paranasal sinus, COPD, reflux esophagitis and depression.


Fig.1 Initial situation of the deceased.

The forensic post-mortem examination on site showed a laceration on the scalp and some superficial scratch lesions on the back, arms, hands and legs of the man. As there was no external evidence of a penetrating trauma, the lesions on the back must have been misconstrued as stab wounds.

Besides the lacerations, the autopsy of the well-developed and nourished man revealed scars typical of self-harm, tablet-suspicious gastric content, and early signs of decay, which meant that pre-existing conditions could not be confirmed.


Fig.2 Two plastic bags containing white tablets.

The benzodiazepine etizolam was reliably identified in the stomach content and in the powdered form. In addition to etizolam, the active metabolite α-hydroxyetizolam was also qualified in urine. The quantitative examinations revealed the presence of caffeine at a concentration of 190 mg/L and etizolam at a concentration of 0.77 mg/L in femoral blood and a caffeine concentration of 426 mg/L and etizolam concentration of 2.82 mg/L in cardiac blood.


Fig.3 Tablet with the imprint XANAX.

The results of hair examples indicated that the decedent was an active or passive consumer of cannabis and a regular but not excessive consumer of amphetamine. The detected amount of cocaine indicates a very rare consumption or an external contamination. Acute toxic effects of etizolam and caffeine were determined as the cause of death.

The present case may have resulted from a misidentification of the drug, which was declared as XANAX, the trade name of alprazolam. Alprazolam is, like etizolam, commonly used for the short-term management of anxiety disorders. Reports of counterfeit Xanax tablets containing etizolam and fentanyl have been confirmed in the USA in 2016. Asian and Latin American markets are most affected by counterfeit incidents. Etizolam and caffeine can be purchased online, which makes it easy to incorporate the substances into counterfeit products.

The fact that the tablets were found in big plastic bags and not in trademarked packaging indicates that they may have been purchased on the internet or via other illicit means. The combination of two psychoactive substances, an upper and a downer, in ranges considered to be potentially lethal, created an unforeseeable deadly risk—the sedative effect of etizolam could have been suppressed by caffeine and masked or complicated the man’s awareness to his delirium.

-

HELP A PERSON WHO MAY BE STRUGGLING WITH ADDICTION

If you or someone close to you needs help for a substance use disorder, talk to your doctor or call SAMHSA’s National Helpline at 1-800-662-HELP (US) or go to SAMHSA’s Behavioral Health Treatment Services Locator.

Learn about naloxone, a life-saving drug that can reverse the effects of an opioid overdose when administered in time.

Good Samaritan Laws in your state protect overdose victims and people seeking medical help for an overdose victim from drug possession charges.

-

This post is for educational purposes only and is nonprofit. Under Section 107 of the US Copyright Act of 1976; Allowance is made for "Fair Use" for purposes such as criticism, comment, news reporting, teaching, scholarship, and research. OP is not a medical expert. No copyright infringement intended. This post does not encourage or glorify violence/harassment. Images might have been upscaled and enhanced. Text might have been shortened and simplified/reorganized for online view.

[The Krokodil]

Ive herd of people overdosing off cocaine and even weed that has been laced with fentanyl. Be careful who you get your shit from!

[K53]

He had a death sentence.

[thckoitin]

Originally Posted by The Krokodil ↗

Ive herd of people overdosing off cocaine and even weed that has been laced with fentanyl. Be careful who you get your shit from!

Fentanyl is everywhere. It's so little size packet what you get over the border and there is real money to be made.
Profits are so big with that kind of potent they don't care too much about people's lives.

[heresy23]

Damn etizolam. , that shit destroyed my life for a few years until I finally got clean !!

[CatBatMan]

Those look exactly like the name brand 2mg “Zanny Bars” that I had a love/hate relationship with many years back. And I’ll tell you for the last time, I did NOT have a drug problem. I’d send a text and have drugs, no problem!

[kilyurselph]

My Cousin, who was like a brother to me, was killed when he took what was sold to him as a percocet in 2020. It looked exactly like any other percocet but turned out to be twice the lethal amount of fentanyl.

[TheUrinator]

I’ve been taking pain killers for many years as a chronic pain management patient. I know that I’m addicted but also comply with the contract I signed with my doctors. If my prescriptions stopped suddenly and I had to find pain killers on the “street” I’m pretty sure I would overdose on fentanyl laced pills if they were pressed to look like regular pharmacy grade pills. I take 30mg hydrocodone every day as 10/325. If I took bootlegged 5/325 what I think may be a safe dose would actually kill me if it were fentanyl tabs.
Part of the fentanyl epidemic is being caused by the crackdown on Pain medication. People who actually need pain pills could not get them so it created a black market. Instead of safe pharmacy grade medicine being available, a whole industry of fentanyl has been made to fill the demand. Our drug laws have created cartels. For whatever reason we have not as a society learned basic supply and demand principles.
There was a time when cocaine was sold legally at practically every general store in America. It was cheap and there were no cartels or gangs selling it. Instead of banning substances and inadvertently creating black markets, what if we dealt with the addiction issues with those substances?
Imagine if the trillions of dollars that the gov has spent on prisons, on DEA, on the wars on drugs, and all the other costs associated with the outlawing of drugs were used instead on research and development on non addictive, safe, and legal substances to fill the demand. Nature has already given us several non addictive medications and substances. We are in a vicious cycle of problems with current drug policies and laws. Making criminals out of users has not worked and will never work.

[DevanteB92]

I got off 4 months ago. I don't think the Pharmacy will lace my Suboxone.....I hope not. Better off than on.

[DeadJeff]

I used to be a junkie, many years ago, doing everything I could get my hands on from the street. I'm so glad I don't do that anymore. Too risky. If I don't get it from a real pharmacy/doctor, I don't take it. People score from the street, then carry it in an old Rx bottle to seem legit... Be careful!