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Substance X and Quinine Are Outdated Concepts
Some of Speers' research is based on clearly outdated concepts.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.