triptonaut34 wrote:I know I am late to this discussion, but...
Quote:Vomitus was noted on the bedding and around the decedent's head on the floor.
Has anyone considered that the victim aspirated on their own vomit? Many deaths attributed to opioid overdose are actually the result of this. This is why I always recommend that anyone who is intoxicated and about to pass out lie in the recovery position.
Either that, or the additive CNS depressant effects of alcohol combined with mu agonism, resulting in severe respiratory depression. If kratom alkaloids are a2 agonists as
this paper suggests, that would further contribute to the sedation and orthiostasis, along with the strong h1 blockade from the benadryl and mirtazapine.
For the nth time everyone, DON'T MIX DEPRESSANTS!!! Please & thank you. RIP to the deceased, but hopefully this story can prevent at least one overdose.
Thank you for adding your input to this discussion!
It is most likely that the victim did indeed die from aspirating/asphyxiating on their own vomit during sleep (in a manner similar to how John Henry Bonham died). Kratom (via opioid receptor activity and GI irritation) and ethanol both promote emesis (yet ironically enough diphenhydramine and mirtazepine may produce anti-emetic effects via modulation of histamine activity). I, too, would hypothesize that the victim vomited during sleep, and died of asphyxiation as it
Also, adrenoreceptors (alpha 1 & alpha 2 in particular) have multiple binding sites, and can product both excitatory and inhibitory effects depending on exactly how the drug tickles these binding sites.
It is a very complex subject, especially given that mitragynine bears a strong structural resemblance to yohimbine. As thus, I would be hesitant to bring the noradrenergic features of this OD into play just yet, especially so given that ethanol itself has profound effects on noradrenergic neurotransmission, as well.
I wholeheartedly agree with you on not mixing CNS depressants in such irresponsible manners, as well as advocating that those who do sleep in the recovery position under tight supervision. My well wishes and prayers go out to the poor victim and his family.
Edgar Allen Poe wrote:In Pace Requiescat
'"ALAS,"said the mouse, "the world is growing smaller every day. At the
beginning it was so big that I was afraid, I kept running and running, and I was glad
when at last I saw walls far away to the right and left, but these long walls have
narrowed so quickly that I am in the last chamber already, and there in the corner
stands the trap that I must run into." "You only need to change your direction," said
the cat, and ate it up.' --Franz Kafka