Toxicology

The police ordered a toxicology report as part of the investigation into Mike’s death.  I spoke to the detective about the results the week before the memorial.  The toxicology report showed nothing.  No blood-alcohol level, no illegal drugs, and no prescription medication.  There was nothing at all in his system.

What do these results tell us?

First, the results tell us that Mike was not intoxicated when he killed himself as we had originally thought.  He had no trace of alcohol in his system.  I can’t say he was sober, because in his suicide note he talked about how he was drinking again.  He may not have been drinking that night (or that morning—we’re not sure if he stayed up late or got up early to end his life), but he had been drinking in the weeks before his death.  I also can’t say he was sober, because to me, sober means having a clear mind.  Although he may not have been drunk when he died, he was under the influence of his mental disease.  Nevertheless, the idea of him reaching the conclusion he did without his crutch, demonstrates to me how much pain he was in.

Second, the results tell us that Mike did not commit suicide because he was taking Chantix.  We read that Chantix, an anti-smoking drug, has been linked to dozens of suicides, prompting an FDA investigation and stricter warning labels.  We know that Mike was taking Chantix in spring of 2009 to help him stop smoking, and that Mom and Dad told him to stop taking it.  When they cleaned out his apartment, they found an unfilled prescription for Chantix.  It seemed like one day Mike had been happy, the next he was stressed out, and then he was gone.  Given his rapid decline, it was hard not to wonder if something other than his own body chemistry caused his death.  Early on my parents seemed to disagree about the cause of Mike’s death.  Mom said it was the depression that killed Mike, whereas Dad believed it was the Chantix and talked about getting a lawyer or joining a class action lawsuit.  We learned that Chantix doesn’t linger in one’s system, and would therefore only be a factor if he had still been taking it.  With the toxicology results, we know we can’t blame the drug for Mike’s death.

Third, the results tell us that at some point Mike stopped taking his anti-depression medication.  We don’t know when he stopped, and we don’t know how he stopped.  We don’t know if he tapered off under the supervision of a doctor, or decided to quit suddenly on his own.  Either way, it was a life or death decision for him.  Mike was diagnosed with severe depression after his first suicide attempt at 16.  He was on medication ever since—or so we thought.  Mom would ask him occasionally if he was still taking his meds, and he would say yes.  How can you make a grown man who lives in another state take his medicine?  If Mike went off of his medication suddenly, he may have experienced withdrawal or SSRI discontinuation syndrome.  Again, a rapid withdrawal might explain his rapid decline.  Then again, antidepressants stay in one’s system longer, so if he had gone off of his meds right before he died, surely they would have appeared in the toxicology report. 

So what the toxicology report confirms is what we already knew:  Mike’s own brain chemistry convinced him to stop taking his medicine, to stop reaching out for help, and to stop living his beautiful life.