Fatality Involving the Ingestion of Phenazepam and Poppy Seed Tea

Abstract

Phenazepam is a benzodiazepine derivative that has been in clinical use in Russia since 1978 and is not available by prescription in the United States; however, it is attainable through various internet websites, sold either as tablets or as a reference grade crystalline powder. Presented here is the case of a 42-year old Caucasian male who died as the result of combined phenazepam, morphine, codeine, and thebaine intoxication. A vial of white powder labeled "Phenazepam, Purity 99%, CAS No. 51753-57-2, Research Sample", a short straw, and several poppy seed pods were found on the scene. Investigation revealed that the decedent had a history of ordering medications over the internet and that he had consumed poppy seed tea prior to his death. Phenazepam, morphine, codeine, and thebaine were present in the blood at 386, 116, 85, and 72 ng/mL, respectively.

Phenazepam abuse in Finland: Findings from apprehended drivers, post-mortem cases and police confiscations

“…Moreover, in a Russian clinical experiment a large single dose (3 mg/5 mg) of phenazepam was given to two healthy volunteers resulting peak whole blood concentrations of 0.024 mg/L and 0.038 mg/L, respectively [8]. In a phenazepam-related fatality, a 42 year old obese man was found dead and a post-mortem (subclavian) blood concentration of 0.386 mg/L of phenazepam was measured [13]. In this case morphine and codeine were found to have also contributed to his death.…”

“…In 2003, which is the year when the zerotolerance law for illicit drugs and driving was introduced in Finland, there were only 20 positive phenazepam findings among apprehended drivers [10]. Increasing phenazepam abuse has been reported from Sweden, the UK and the US [11][12][13]. Phenazepam is very easy to order from the Internet.…”

Phenazepam: The drug that came in from the cold

“…The cause of death in this case was attributed to multidrug toxicity. 3 In the third case, the deceased had consumed phenazepam, together with other prescribed medication. Blood analysis revealed morphine (360 mg l À1 ), codeine (380 mg l À1 ) phenazepam (2520 mg l À1 ) paracetamol (no concentration given) and olanzapine (no concentration given).…”

Differences existing between USA and Europe in opioids purchase on Internet: an interpretative review

“…These poppies, used to produce infusions, caused in the young man a dependence with a consequent need of hospital admission and rehabilitation (Lieberman, 2001). Bailey et al (2010) describe another dramatic case, related to the poppy seed tea consumption, with a fatal conclusion. The patient, a 42 years old U.S. man, died after the contemporary consumption and intoxication of several drugs, such as phenazepam, morphine, codeine and thebaine.…”