In the wake of Saturday’s news that Whitney Houston had been found dead in the bathtub of the Beverly Hilton hotel, the exact cause of her death remains a matter of speculation. Houston was reportedly found submerged under water,
but whether she drowned because she was unconscious or she was already
dead before she slipped under water, there still remains the question of
which chemicals were involved in the process.
Houston
had battled publically with pills, alcohol, and cocaine in the past.
There were prescription medications in her hotel room—reportedly
including Xanax—and Houston was seen around Los Angeles visibly
disheveled and erratic, sources say.
Houston’s death would appear to be yet another cautionary tale in an escalating story line.
In
recent years, as the use of prescription medication has proliferated in
the United States, so too have the abuse of and overdose from many of
these substances.
Prescription-drug
abuse is the fastest-growing drug problem in the U.S., says a report
issued last month by the Centers for Disease Control and Prevention. The
same report states that in 2007, there were roughly 27,000
unintentional deaths from drug overdoses—or one death every 19 minutes.
But
of all the things that people ingest, there are few combinations more
life-threatening than alcohol and benzodiazepines—the class of sedatives
that includes Xanax, Valium, and Klonopin.
The
reason? When taken together, alcohol and Xanax have what’s known as an
additive effect, which means that in the presence of Xanax, alcohol is
made more potent than it would be alone.
Both
alcohol and benzodiazepines work by depressing the central nervous
system of the body, reducing the activity of several broad-stroke mental
functions, such as thought, memory, coordination, and respiration.
“It’s
hard to overdose on Xanax alone,” says Dr. Ken Thompson, medical
director at Caron Treatment Centers, although, he is quick to add that
it’s not impossible.
But
unlike alcohol, Xanax only affects one specific type of brain receptor.
Therefore, the mechanism by which it can influence brain function is
constrained.
“Alcohol
doesn’t have that limit, but often people will pass out before they
drink enough alcohol for it to be lethal,” Thompson says. “You take the
two together and you have a totally different picture.”
“Your
usual three drinks is actually six,” says Dr. Karen Miotto, professor
of clinical psychiatry and director of the Alcoholism and Addiction
Medicine Service at UCLA's Semel Institute for Neuroscience and Human
Behavior.
Because
of the additive effect of combining the two substances, it becomes
impossible to know just how your body will absorb the alcohol you’ve
ingested. Throw in other factors—sleep deprivation, an empty stomach, a
cold—and the mixture is made all the more unpredictable.
“What
I think is the most tragic aspect of this combination is that you can
get amnesia. So not only is it additive in terms of the respiratory
effect, but the amnesic effect is additive,” Miotto says. “You can get
people who die accidentally in the truest sense of the word. They don’t
remember how many drinks they had, or how many pills they took.”
Miotto notes that one common cause of death that she sees is when college kids, having taken this combination of substances, find themselves feeling unexpectedly drowsy and get in the shower to try to wake up.
Miotto
notes that one common cause of death that she sees is when college
kids, having taken this combination of substances, find themselves
feeling unexpectedly drowsy and get in the shower to try to wake up.
Because they’re so sedated, their natural ability to “right
themselves”—something which humans are naturally good at—is handicapped,
and they can wind up inhaling water and flooding their lungs.
Any
benzodiazepine is highly dangerous in combination with alcohol, but
Xanax is perhaps the most dangerous, because it is more fast-acting than
the others. Because xanax and alcohol both work on the brain at a
rapid-fire pace, their mutually enhancing effect is bolstered compared
to slower-acting benzodiazepine like Klonopin, which peaks in the brain
more slowly, after the effect of the alcohol may have already begun to
decline.
In
fact, it is this same rapid action that makes Xanax the most addictive
of the benzodiazepines, many neuroscientists believe, providing the
sensation of a high more so than other drugs of its class.
The
Los Angeles county coroner’s office has announced that it won’t be able
to confirm the exact cause of death until the toxicology reports come
back, which might be as long as a few weeks.
The
report can take so much time to complete because the testing process is
much more specific than the initial screening process. It is able to
differentiate, for instance, which benzodiazepine was ingested, as well
as every other chemical substance in the body.
It is much less likely to produce a false positive, adds Dr. Thompson, than an initial screening test would be.
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