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Local news: "autopsy confirms LSD overdose"

Migrated topic.

Last friday, local news reported on a drug overdose at a festival:
Original article (Dutch, short)

Here's a quick translation:

Friday night, Dour festival was marked by a drug death, the district attorney of Bergen reports.
A French festival-goer, a twenty-year old, died from an LSD overdose.

Together with some friends, the young man had purchased LSD. After taking it they all felt unwell. Poor quality of the drug was probably the reason of the man's death. The dealer has been arrested.

I googled around for different news websites, to see how they handled the story, and if what if any user comments were to be found. Interestingly enough, most news outlets copied this story, but some of them explicitly omitted only the sentence where "poor quality of the drug was probably the cause of the man's death". As for user comments, 90% were ignorant knee-jerk comments in the vein of "Nice, that's one less" or "How about we stop paying these drug addicts medical insurance and let them kill themselves", though it was nice to see there were at least two comments posting some facts on the safety profile of psychedelics, or pleading for test kit availability at festivals.

A follow-up story was posted today:

Article (again, Dutch)

The French festival-goer that died last weekend at Dour festival certainly did die from drugs.
An autopsy performed on sunday determined that the victim died from an LSD overdose. That is what the district attorney of Bergen reports today.

The man, hailing from the city of Périgueux in the southwestern region Dordogne was a twenty year old. He died friday night.

I'd love to see that autopsy report :thumb_dow
The sheer level of ignorence and/or misinformation here is just staggering.
First of all, there is no such thing as "poor quality LSD". LSD = LSD = LSD or != LSD.
They obviously mean to say "It was a different substance altogether", but who cares, right?
Then, there is this autopsy which somehow (correct me if this is possible, but it seems farfetched to me) detected overdose amounts of LSD in this man's body two days after he died. Seriously?
I know I shouldn't expect anything else from the media and/or law enforcement, but I felt like venting some frustration here.. :?
Until the toxicologist/mortician conducting the autopsy does indeed find ACTUAL post-mortem evidence (i.e. GC-MS, TLC, HPLC, etc.) that there was LSD in his system, as well as the concentrations in his bloodstream, I can only doubt it was LSD which caused him to bite the dust. My primary suspicion is that this dumbass was slipped some 25-x, DO-X or some other super potent, super dangerous phenylethylamine at this "festival". RC phenylethylamine (& tryptamines in the case of a few such as some SERT derivatives and alpha methyltryptamine) hallucinogins are infamous for their super steep dose-response curves, and are SUPER deadly if administered at too high a dose, which is very possible given that there have been numerous case reports of people taking GIGANTIC doses of LSD (e.g. thumbprints, the time those 4 people were slipped crystalline LSD instead of cocaine, etc.) and ending up just fine [READ: Not actually dead], albeit mind-fucked out the wazoo for their next fifteen lifetimes. There were no concrete figures in this article concerning the post-mortem serum concentrations of this "Bad LSD" and, given the high proliferation of dangerous LSD-like drugs being marketed as Lysergide at music festivals accross the world, I would have to assume that, as per the unfortunate norm, the news media jumped the gun on this tragedy. I have reason to suspect that it was most likely an NBOME or DOx which induced this death, as these drugs have killed before, and will continue to kill people en masse until reagent testing becomes the norm at these kinds of things (then again, some people just wanna die anyways, so why not at least let 'em die knowing just what exactly is killing them?). I hope these overly-zealous, overly-hasty and horribly undereducated "journalists" have the balls and morals to inform the public of their mistake, admitting that he was probably on a cocktail of dangerous drugs (with the grocery list w/post-mortem serum concentrations available for all to see) as well as other activities such as chronic dehydration and reckless behavior which contributed to his passing. Some infantile part of me empathizes with that poor bastard, but the rest of my conscience is just about ready to blow up like the world trade center at the sight of this avalanche of misinformation being broadcast to the general public. Unfortunately, unlike other toxic industries, recalls don't seem to work so well for the mainstream media, who can say just about whatever in the hell they want to say so as long is it keeps the presses hot.
Maybe he had LSD in his system, but we don't know if this person had medical issues, or was on other substances or prescription medication...

Less than a handful of deaths have been directly attributed in the medical literature to the pharmacological effects of LSD, and none of these have been unquestionably attributable to LSD's actions. Estimates of what could be a potentially lethal dose of LSD are higher than 10 mg orally, a dose that is more than 100 times the common, moderate dose of LSD (100 ug). The administration of this amount would require the ingestion of more than 200 units of street blotter, which typically contain about 50 ug of LSD (as of late 2010).

It is important to note that LSD has been associated with deaths as a result of inebriated behavior (falling from a height or fighting with police) or by suicide. There are also occasional deaths misattributed to LSD when another substance was actually taken.

I'm not sure how this person could manage to get above 10mgs of LSD in their system...

Dangerous Interaction: Lithium or tricyclic antidepressants. LSD can cause dangerous reactions when used by someone taking lithium or tricyclic antidepressants. Some people report having experienced seizures after ingesting these combinations. Individuals have typically reported an undesirable intensification of the hallucinogenic response that is not akin to "getting higher for free". Such people have reported being unable to communicate with their friends, becoming uncharacteristically violent or going into fugue states (ending up somewhere else without knowing how they got there). In addition, the interaction of lithium and LSD has been reported by some persons to result in seizures in those who do not have a history of this condition

Hyperthermia/Overheating. While uncommon, a few cases have been reported in the medical literature of dangerous overheating following ingestion of LSD, including one non-fatal case that brought the patient's body temperature to over 106°F (41°C).6 -erowid

This was at a festival right? Hyperthermia/Overheating seems more likely to be the cause of death than LSD toxicity...

Put simply, LSD does not cause death at recreational or therapeutic doses (less than 500 ug / 0.5 mg). An increase in news articles in 2012/2013 suggesting deaths related to LSD are almost all related to 25I-NBOMe and 25C-NBOMe, two new chemicals, available on blotter, but completely different from LSD. While there are substantial reasons why users should be cautious about LSD use (see LSD Health), death is not a major risk.

Less than a handful of human deaths have been tied in the medical literature to the pharmacological effects of LSD, and none of these deaths have been unquestionably attributable to LSD's actions. The clearest case was documented by Fysh et al. in 1985; however, they fail to explain the circumstances of the death, only discussing the toxicological assessment, casting some doubt that the only explanation for the death was LSD.

Estimates of lethal doses of LSD are higher than 10 mg (10,000 ug) administered orally, more than 100 times a normal moderate dose of LSD (100 ug). The administration of this amount would require the ingestion of more than 200 units of street blotter, which typically contain about 50 ug of LSD (as of late 2010). LSD has been used by tens of millions of people over the last 50 years and has been administered to tens of thousands of patients in psychotherapeutic settings (mostly prior to 1960).

Some suicides have been tied to the use of LSD, though it is difficult to positively link an individual's choice to take their own life with their past use of LSD. In general, LSD is not reported to substantially increase the risk of suicide and those who do commit suicide after taking LSD are likely to have suffered from pre-existing suicidal tendencies.

Some deaths have been associated with inebriated or combative behavior while under the influence of LSD, including falling or jumping from a height or dying after being beaten by police.

Because the numbers of fatalities associated with LSD are so low, it is difficult to determine the risk of death associated with LSD. Erowid estimates that the risk of death from taking LSD is probably less than one death per million LSD use sessions, with risk of death higher among those predisposed to suicide and among those without a sober sitter present to help avoid accidents or fights.

In his 2001 book "Illegal Drugs: A Compete Guide to Their History, Chemistry, Use and Abuse", Dr Paul Gahlinger states "LSD is not toxic in the biological sense.". A 2008 review of the scientific literature titled "The Pharmacology of Lysergic Acid Diethylamide: A Review", by Passie et al. gives the number of pharmacological fatalities from LSD as zero: "There have been no documented human deaths from an LSD overdose."

Pharmacological fatalities are those deaths caused by the direct action of a plant or drug in the body, not including deaths caused by accidents or as a result of inebriated behavior. Generally, LSD is considered to have a very low risk of death. As Haddad and Winchester stated in 1990, "No well-documented human deaths resulting directly from the toxic effects of LSD itself have occurred, though LSD has been implicated in accidental deaths, suicides, and homicides."1 And in Psychedelics Encyclopedia, Peter Stafford summarizes:
For those concerned about immediate medical hazards in ingesting LSD [...] Abram Hoffer has estimated, on the basis of animal studies, that the half-lethal human dose--meaning half would die (a standard measure for drugs)--would be about 14,000 [ug]. But one person who took 40 mg. (40,000 [ug]) survived. In the only case of death reportedly caused by overdose ([Griggs and Ward, 1977]), the quantity of LSD in the blood indicated that 320 mg. (320,000 [ug]) had been injected intravenously.2
Possible Pharmacological Fatalities
Though LSD can result in increased body temperature and vasoconstriction at high doses, there are less than a handful of documented deaths or near-fatal medical cases relating to the pharmacological action of LSD in humans. None of these include enough documentation to prove unquestionably that LSD has, by itself, resulted in a person's death. Below are the best documented possible pharmacological fatalities that we have been able to find attributed to LSD.

Incident: 25 Year Old Male, 1985 #
The lack of specifics about the context or any documented symptoms the decedent had leaves some doubt about the finding that this was an LSD-caused death. The patient died 16 hours after being admitted to the hospital and no details are given about his condition. In later cases (such as those of Martin Cotton or William Parker Martin), LSD was listed as a cause of death by a coroner where more plausible causes of death were the injuries received in fights with police officers. We know nothing of the specifics of what lead to this unidentified man's death.
Fysh RR, Oon MCH, Robinson KN, Smith RN, et al. "A Fatal Poisoning with LSD". Forensic Sci Int 1985 Jun-Jul;28(2):109-13.
"Radioimmunoassay, high-performance liquid chromatography and capillary gas chromatography-mass spectrometry were used to detect and measure LSD in the first reported case of fatal poisoning by LSD. [...] In a recent case [...] a 25-year-old male died 16 h after being admitted to hospital, and a Coroner's enquiry concluded, on the basis of the medical and toxicological evidence, that the actual cause of death was poisoning by LSD. This paper describes the toxicological aspects of the case in which LSD was analysed in ante- and post-mortem samples by various techniques."
Incident: 34-year old male, 1977 #
Questions remain about the cause of death in this case, as a month passed between the time of the victim's death and his body's discovery (complete with rodent bites) in a warehouse.
Griggs EA, Ward M. "LSD Toxicity: A Suspected Cause of Death". J Ky Med Assoc. 1977 Apr;75(4):172-3.
"An extremely high liver tissue level of lysergic acid diethylamide (LSD) was measured in a 34-year-old male in whom autopsy showed no anatomic cause of death. Death from LSD overdose apparently has not been previously confirmed toxicologically. The possibility that this case represents death due to toxic effect of LSD is discussed."

"A partially clothed 34-year-old male was observed while engaged in bizarre behavior, and was subsequently accosted during an attempted break-in in November, 1975. He fled the scene and was found dead in a deserted warehouse, one month later. An autopsy was performed to ascertain, the cause of death."
Incident: No deaths, but eight near-fatal overdoses, 1975 #
These case reports do not document a death, but do provide details about serum and gastric levels of LSD after a group of major non-fatal overdoses. The article describing these case reports explains that these patients mistook the powdered LSD for cocaine.
Klock JC, Boerner U, Becker CE. "Coma, Hyperthermia, and Bleeding Associated with Massive LSD Overdose, A Report of Eight Cases". Clin Toxicol 1975;8(2):191-203.
"Eight patients were seen within 15 min of intranasal self-administration of large amounts of pure D-lysergic acid diethylamide (LSD) tartrate powder. Emesis and collapse occurred along with sign of sympathetic overactivity, hyperthermia, coma, and respiratory arrest. Mild generalized bleeding occurred in several patients and evidence of platelet dysfunction was present in all. Serum and gastric concentrations of LSD tartrate ranged from 2.1 to 26 ng/ml and 1000 to 7000 ug/100 ml, respectively. With supportive care, all patients recovered."

I would say there are too many unknown variables to attribute the death to LSD toxicity...

I would like to know more about this situation...

I'll leave with comments by Dr. David E. Nichols:

The primary health concerns about LSD use are related to psychological health rather than risk of physical damage to the body or brain. As senior LSD researcher Dr. David Nichols, Distinguished Chair of Pharmacology at Purdue University and head of one of the world's top LSD research labs, stated in his 2004 review article on hallucinogens, "There is no evidence that any of the hallucinogens, even the very powerful semisynthetic LSD, causes damage to any human body organ. [...] Hallucinogens do not cause life-threatening changes in cardiovascular, renal, or hepatic function because they have little or no affinity for the biological receptors and targets that mediate vital vegetative functions." Deaths resulting from the pharmacological effects of LSD are rare to non-existent. -erowid

First of all, there is no such thing as "poor quality LSD". LSD = LSD = LSD or != LSD.

that's not accurate.

there are 4 possible LSD isomers: 6R,9S, 6S,9R, 6S,9S, and 6R,9R. Only the latter is centrally active.
many batches contain a certain degree of mixtures of the isomers. when people refer to poor quality LSD, they are commenting on the lack of separation of the isomers, and/or the intermediate byproducts of LSD synthesis.
In probing possibilities:

we talk about the south of Belgian so the department of autopsy analysis has a funding of 24.5 euro per day which is spend on candy rather than on calibrating materials. The investigating "doctor" Monsieur medecin is a friend of a brother-in-law of a locally idolized overly corrupt politician and he Docteur is an alcoholic of course, just like the others btw as it forms the social tissue of old ages. He had to make a report anyhow (or how a day can turn sour) and searched google on "drugs". He went for pictures as plain text is too difficult. There he found this:


All those complex words would ruin the day, but L.S.D was doable to remember.
Case closed, it was drug dead lsd.

^^ This :) You nailed it Jees!

I think the Dour festival must have the most irresponsible crowd ever, cause each year there's at least one dead there.
Probably over 50% of the crowd is going there to get 'fucked up'. Just buy everything you can get your hands on and swallow that shit....
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