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March 03, 2014 9:53 AM Hoffman and the Hype about “Killer Heroin”

By Keith Humphreys

Within hours of the death of Philip Seymour Hoffman, rumors spread that this magnificent actor had been taken from us by “killer heroin”. The threat of a batch of impurity-laced, unusually potent heroin is a staple of opioid overdose news coverage and popular debate. But it’s usually hype.

Hoffman’s tragic overdose was absolutely the norm: He died from a combination of drugs, not from impure or unusually strong heroin. The benzodiazepines may have been particularly lethal in that they, like alcohol, seem able to lower acute tolerance for opioids, thereby turning a user’s standard dose into an “overdose”.

Two people who will be totally unsurprised by Hoffman’s toxicological test results are addiction researchers Shane Darke and Michael Farrell:

If there’s one thing we can quite clearly say about heroin deaths, it’s that impurities are rarely, if ever, found or are relevant to the death. Those that are found are typically innocuous substances, such as sucrose.

Data on overdose deaths from legally-manufactured prescription opioids are the other reason to doubt the killer heroin hype that so regularly grips the media. Prescription painkillers are consistently pure and of knowable dose, yet they kill 5 times as many Americans a year as does heroin.

Keith Humphreys is a professor of psychiatry and behavioral medicine at the Stanford University School of Medicine.

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