What The Toxicology Report Says About Elliott Smith’s Mysterious Death.

One aspect of Elliott Smith’s story that hasn’t been examined enough is the role that prescription drugs supposedly played in his death.

During the Q&A after Gil Reyes’ documentary, it was said Elliott quit at least 10 psychiatric medications, cold turkey, within a few days of his suicide….

In the 2004 Spin article, Jennifer Chiba declared to Liam Gowing:

‘In mid-September, the effects of going cold turkey were apparent. “I came home from seeing Lost in Translation and he was lying in the bed with his arm bleeding,” says Chiba. “He had seven old cigarette burns on his arm. It was evidence of his pain from that heroin and crack period that was just a little too real, so he’d taken a knife to it. It was on a Friday, so we went to the doctor on Monday and found out that he’d abruptly stopped taking one of his medications [Strattera]. It’s so dangerous. It throws you so off-balance. You can’t just go off that. So from then on, I got a pill organizer with the days of the week, and I would administer the meds.’

The problem is that these declarations do not fit with the toxicology report findings. This is what was found in his blood:

Amphetamine (Adderall): 0.30 µg/ml

Atomoxetine (Strattera): present

Mirtazapine (Remeron): < 0.10 µg/ml

Buprenorphine (Buprenex): Done

Clonazepam: < 4 ng/ml

Gabapentin < 2.0 µg/ml

All the other drugs tested (alcohol and a long list of illegal drugs) were found negative.

I am not an expert but the doctors said at the time he had normal doses of these prescription drugs, and the Strattera mentioned by Chiba in 2004 was present when he died. Strattera, like Adderall, is used to treat ADHD in adults and most sites say it can be discontinued without being tapered anyway. But still, that was not the case as he had Strattera in his system at the time of his death.

Mirtazapine (Remeron) is used to treat depression and data I found online indicate that therapeutic levels should be between 0.039 and 0.18 µg/ml, so Elliott’s level (around 0.10 µg/ml) was totally in the range.

Buprenorphine is used to treat opioid addiction, to control chronic pain (he was still suffering from his beating by the police).

Clonazepam and Gabapentin are used to treat seizures but also anxiety, panic and sleep disorders (probably what he was suffering from).

And if you look for how long amphetamines (Adderall) for example stay in your system, it is not very long! Amphetamines have a plasma life of 4-6 hours, so after 48 hours about 0,02 % of the original dose is left in the body, meaning that after 72 hours the level is completely below detectable concentrations, so he had taken his meds very recently.

Who knows, he may have tried to quit his meds at one point, but what Elliott did years and months before does not matter; what is important is that he had taken his meds at prescribed levels when he died and thus we cannot blame any withdrawal symptoms.

And the most ridiculous part of the story is that, at other occasions, people have blamed an excess of prescription drugs as the cause of his suicide! As Gil Reyes said in an interview: ‘According to friends, it was a combination of prescription drugs, illegal street drugs, and alcohol over a period of years. There’s much talk about how Elliott’s doctors could have done a better job monitoring his condition.’

I have to repeat it: he had a normal dose of prescribed meds the day he died, hadn’t drunk any alcohol nor taken any street drugs,… no cold turkey, no overdose and all other stories you may have read or heard are lies.

Originally published on Rock NYC (May 22, 2012)
©AlysonCamus