My
Response To Bradley Speers' Rebuttal
by Roger Lewis 6/14/98
Introduction
Recently a 21-year-old Pharmacology student named
Bradley Speers wrote "A Rebuttal against the Dead Men Don't
Pull Triggers essay written by Roger Lewis." I welcome
Speers' desire to better understand the technical details.
Unfortunately, several of Speers' key points are
fundamentally
flawed.
No Parallel To Cobain Case
Most importantly, Speers does not
provide another case in which a
heroin addict overdosed and
suffered a self-inflicted gunshot wound.
Only one case is
mentioned in Speers' entire rebuttal, and the case
itself is
completely irrelevant to the Cobain case because instead of
relating
even remotely to intravenous heroin use, Speers' citation
concerns
morphine tolerance during a two and one-half hour period, in
which
the method of administration is not described.
Wrong Focus
Speers makes a big mistake when he overestimates
the relevance of
dose-related data compared to the data
concerning the blood morphine
level. Most importantly, Speers
fails to recognize some fundamental
differences between crucial
concepts such as method of administration
(eg. intravenous as
opposed to "bolus"); high dose versus overdose;
and
even the basic differences between heroin and morphine.
Substance X and Quinine Are Outdated Concepts
Some of Speers'
research is based on clearly outdated concepts.
Specifically, he
mistakenly contends that the lethality potential of
intravenous
heroin is directly correlated to the toxicity associated
with
"Substance X" and/or "quinine." Some of the
confusion about this
subject stems from Milton Helpern, M.D., who
wrote a very important
study in the early 1970's (Fatalities from
narcotic addiction in New
York City - incidence, circumstances,
and pathologic findings, Human
Pathology, 1972; 3(1): 13-20).
Several findings made by Helpern have
long since been studied
further and found wrong, with the relevance of
quinine standing
as a prime example. From my essay:
"Nakamura explains 'In more cases, it can be now shown that
narcotic
was taken and rapidly distributed by the body to the
various organs,
and it may now be unnecessary to explain narcotic
deaths by blaming
excipients or hypersensitivity responses.'
(63). Thus, although some
rare overdoses can be attributed
partially to hypersensitivity,
allergic, and other reactions to
adulterants in street heroin, it is
now widely accepted that
heroin overdoses are primarily 'dose
related.' " (Nakamura,
G.R., "Toxicologic assessments in acute heroin
fatalities,"
Toxicology Annual Volume 3, edited by Winek, C.L. &
Shanor,
S.P., Marcel Dekker Inc., New York, USA, 1979, pp. 75-87.
The advent of better testing methods, accumulating data, and
increasing heroin overdoses all led to indepth research
concerning the
forensic pathology of intravenous heroin
overdoses. One of the time
consuming elements of researching the
Dead Men Don't Pull Triggers
essay was editing these references
to include only the highest quality
and most relevant work. In
stark contrast, Speers describes only one
case history, which is
completely irrelevant, involving a man who took
a large dose of
morphine as a bolus over a two and one half hour
period.
Research Is Central To Homicide Claim
For the record, I have
done a lot more research than Speers on this
subject. Every
single reference listed at the end of my essay was read
by me
more than once, and many have been read several times. I have
scoured seven major libraries in two cities for these references,
including highly specialized facilities devoted to medical and
forensic information, such as Toronto's Addiction Research
Foundation,
and the University of Toronto's Medical and
Criminology Libraries.
Although I used the computer and the
Internet (eg. Medline, Toxline,
et. al.) to peak capacity, and
although I sought any personal
communication possible, I relied
solely on published, respectable
references for the actual essay.
I hand-searched almost every single
issue of every medical and
forensic journal from A to Z since 1965,
making note of the
finest articles and the references therein, then
seeking further
references based on the new information. From
textbooks to
poisoning manuals, I tried to make the research
exhaustive so
that I could honestly reach a conclusion based on all
available
material.
Speers' "Conservative" Judgment Betrayed By Lack Of
Research
Speers' concern to be "conservative" in his
judgment is honourable,
yet his conclusions and his use of
outdated research both betray his
conservatism. Conservative
judgment in this case has been a goal of
mine from the start,
hence I directly compare the Cobain case only to
those cases in
which the blood morphine level was measured (1526
cases) instead
of all cases involving a heroin-related overdose (3226
cases).
Similarly, I directly compare the Cobain case only to violent
suicides, not suicides in general. For the purposes of my essay,
I
conservatively assumed that Cobain was the world's most severe
intravenous addict (if he was not an addict, then the dose of
heroin
he received would be approximately seventy-five times the
maximum
lethal dose). Speers' statement that he likes to be "more
conservative
about things" merely states his intention, not
the reality.
Mechanisms Of Tolerance
Speers is basically correct when he
states that there are "...two
general mechanisms in which
tolerance to drugs can occur," however it
is important for
the reader to understand this is truly a simplistic
description
of a complex subject. Although Speers aptly summarizes the
two
general mechanisms as involving "...the removal of the drug..."
or
"...the increase (or decrease) of receptor numbers...,"
he fails to
understand the limits of tolerance of heroin addicts
to intravenous
heroin. Even Dr. Reay, the Seattle Medical
Examiner, has wisely
remarked that "tolerance is an amazing
thing," so it is hard to
criticize Speers too harshly for
falling into the same faulty line of
reasoning. Regardless of the
"mechanisms" of tolerance, there is an
established
limit to the range of doses which a heroin addict can
survive.
Irrelevant To Measure I.V. Heroin Toxicity Using The LD50
Speers
uses the concepts related to "LD50" doses in a confusing
and
irrelevant manner, for example, when he says "For
addicts, setting a
value is impssible." Toxic substances
such as chemical poisons and
drugs are often measured in
laboratories to better determine their
exact level of safety. For
example, a study conducted on a particular
type of rat poison
could include one hundred rats, and the test would
be to measure
the amount of rat poison needed to kill the average rat.
The
amount of rat poison needed to kill fifty of the one hundred rats
is
the "LD50" of rat poison, i.e. the Lethal Dose for 50% of
the test
group. The LD50 of intravenous heroin is not relevant to
the Cobain
case for two major reasons; first, the LD50 for heroin
is based on
data from non-addicted subjects, and second, the LD50
only tells about
the lethality of the drug in 50% of subjects,
not the entire 100%. The
dose required to kill 100% of the test
subjects is called the "LD100,"
and it is also largely
irrelevant to the Cobain case, because it still
only concerns
normal subjects.
Opioids Accumulate
Speers is also wrong when he comments that
"it may be possible that
there was a reasonable level of
morphine present before a final
injection, and thus its effects
are less pronounced." The level of
opiates accumulates and
eventually reaches a toxic level.
Heroin & Benzodiazepines A Deadly Mix
Regarding the traces
of a diazepam-like substance in Cobain's blood,
Speers seriously
underestimates the danger of benzodiazepines mixed
with heroin.
He also totally neglects to consider the possibility of a
fast-acting benzodiazepine as described in my essay.
Cobain Was Incapacitated Or Dead Before Gunshot
Note that I am
not saying that Cobain died from a "drug overdose,"
rather
I am stating that medical evidence shows he was incapacitated
or
dead due to the heroin before the gunshot was fired, therefore he
was murdered. The information presented in the Dead Men Don't
Pull
Triggers essay has recently been independently and
professionally
validated by award-winning journalists Ian
Halperin and Max Wallace in
their book Who Killed Kurt Cobain?
Overdose Reports Exist Without Any Case Parallel To Cobain's
I
reviewed several dozen heroin overdose reports, and listed them all
in the reference section of my essay to facilitate rebuttals. One
thing rarer than overdose reports is another case remotely like
Cobain's; I found none. Apparently this is because such a case
does
not and cannot exist. There is nothing quite as rare as
something
which cannot exist.
Pro-Murder-Theory Is Not "Pro-Murder"
Although I
clearly state that Cobain was murdered, I strongly object
to
Speers' morbidly callous description of my essay as a "pro-murder"
essay. My essay was written to tell the truth, not to bolster a
biased
preconception, and is more properly seen as "pro-fact."
The phrase
"pro-murder" is at best cheap jargon slang
for "pro-murder-theory,"
and at worst an implication
that I support the general concept of
murder. I realize Speers is
not actually saying I am "pro" murder, but
it is truly
evident of his lack of literary and grammatical skills
that he
would write such a disrespectful description.
Dead Men Don't Wipe Prints Or Use Credit Cards Either
I was
ready to accept that Cobain committed suicide until I read Tom
Grant's website, then I became convinced that Cobain was probably
murdered based largely on circumstantial evidence and Tom Grant's
assurance that he had further, more concrete evidence. Grant has
since
presented a lot more evidence, and says he still has more.
After about
one year of researching the Dead Men Don't Pull
Triggers essay, I was
convinced that significant forensic
evidence existed such that it was
medically impossible for Cobain
to have committed suicide. There are
many reasons for believing
Cobain was murdered, some less technical
than others, and all of
the evidence is important.
Conclusion
Speers is basically a smart young man, and has done
a good preliminary
job drafting his rationale regarding why he
personally believes Cobain
was not murdered in spite of the
evidence presented in the Dead Men
Don't Pull Triggers essay.
Although I am saddened with Speers'
lackluster methodology and I
disagree with all of his conclusions, he
has a good grasp of some
important pharmacological concepts such as
tolerance and
toxicity, and he asks the same questions I asked myself
when
writing the very essay he criticizes. It occurred to me
frequently
while reading his rebuttal, that he has put many hours of
time
and serious thought into this question, possibly a lot more than
the
Seattle Police Department and coroner Nicholas Hartshorne
combined.
Hopefully Speers will at least accept the overwhelming
rarity of
the Cobain case (in contrast to the Seattle Police Dept.,
who
insist it is a "typical suicide"), and join the growing
public
demand for a full and independent re-investigation.