The Toxicology Report
The toxicology report of Kurt Cobain stated that 1.52mg per litre of morphine along with traces of valium (diazepam) were found in his blood.
Tom Grant claims that the amount of heroin found in Cobain's blood is 3 times the lethal dose. His claim is based on a study from a book called Heroin Addiction by Jerome J. Platt where the author wrote that the maximum lethal dose of a 150 pound male would be about 75mg-80mg of heroin. This will result in 0.5mg per litre of morphine in blood. According to Grant, Cobain was injected with minimum 225mg of heroin to get 1.52mg/L of morphine in his blood.
From what I have researched, there is no fixed lethal dose. How much of a dose would be lethal depends on various factors such as the age, gender, health and drug tolerance of the individual. For those who are new to heroin and have never taken the drug before, 75mg of heroin may be a lethal dose for them. However, addicts take the drug regularly and they build a tolerance allowing them to take high amounts of heroin.
One study I found stated that the average intravenous dose of heroin is 466mg a day. This is twice the amount of the triple lethal dose Grant claimed was given to Cobain. Still, Cobain could get murdered if he was incapacitated. However, one thing people always fail to realize is that drugs reduce in amount in blood over time. I learned from one website that it takes 5 hours to 2 days for heroin to become undetectable in blood. It is likely that Cobain had taken heroin hours before he killed himself.
I must explain the following things to you:
- The metabolism of heroin.
- The elimination half-life of heroin and its metabolites.
- Purity and dosage measurements.
After injecting heroin it enters the bloodstream. The blood carries heroin to various parts of the body such as the liver, brain and kidneys. Heroin would metabolize into 6-acetylmorphine (6-AM) and 3-acetylmorphine (3-AM). 6-AM would metabolize into morphine. Morphine would further metabolize into morphine-6-glucuronide (M6G) and morphine-3-glucuronide (M3G) via a process known as glucuronidation.
Heroin and its metabolites are excreted in urine and feces. When the blood carries the drug and its metabolites to the kidneys, the kidneys would filter the blood and transfer the metabolites to the urine bladder. Up to 90% of heroin and its metabolites are excreted from the kidneys. The rest from biliary in the form of feces. Eventually, the blood would get cleansed and no traces of the drug and its metabolites can be detected.
2. The Elimination Half-Life of Heroin and its Metabolites
The elimination half-life, simply called half-life is the estimated time when half of the drug would get eliminated by the body through the process of metabolism and excretion. In blood, usually the drugs would become undetectable after 5 half-lives. In 5 half-lives, around 97% of the drug and its metabolites would get eliminated from the blood. The eliminated drugs are transferred to the urinary bladder and the intestines. One study I found stated that 6-AM would get hydrolyzed into morphine in the urine. The drugs and its metabolites remain in the body until they get excreted.
The following are the half-life of heroin and its metabolites:
- Heroin - 2 to 3 minutes.
- 6-AM - 30 minutes.
- Morphine - 2 to 3 hours.
One dose of heroin can have anywhere between 3% to 99% of heroin. Heroin contains other chemicals as impurities. How much of a dose contains heroin depends on its purity. I read that sometimes water is used to prepare the dose. In such cases, the largest impurity the dose would contain is water. A dose made without water may contain more heroin.
One thing I noticed among the fans who support the conspiracy theory is that there is a misunderstanding about the measurements of the dose. They think 75mg has the same value as 75ml. I have also noticed the authors of the books Who Killed Kurt Cobain? and Love and Death, Ian Halperin and Max Wallace have a similar misunderstanding. In fact, the authors think 75mg of heroin is 75 times the lethal dose for a non-user of the drug.
In one video of Trace Evidence, the claim was made that 600 mg is equivalent to six full syringes. A full syringe here is about 100 units. I also noticed that Tom Grant had commented on that video and it seems he is under the same opinion that a 100 unit syringe has the same value as 100mg.
A 100 unit syringe is equal to 1ml. 1ml does not have the same value as 1mg.
The difference between mg and ml is 1000.
1mg = 0.001ml
1ml = 1000mg
To know how much mg would be in ml we divide the given mg amount with 1000.
Example
75mg = 75 ÷ 1000 = 0.075ml
To know how much ml would be in mg we multiply the given ml amount with 1000.
Example
1ml = 1 x 1000 = 1000mg
Many people who support the conspiracy theory have the dosage measurement incorrect and they erroneously assume the wrong amounts of dosage required to get the lethal dose. You don't need 6 full syringes to get 600mg of heroin. One full syringe of a 100 unit or 1ml capacity has a chance of containing up to 1,000mg of heroin. Grant's claim that Cobain took 225mg of heroin requires only one 100 unit syringe. Not six.
Now let's get back to the Cobain Case.
The conspiracy theory claims that Cobain was incapacitated with heroin and then he was shot with the shotgun by the murderer who later staged the scene as a suicide scene. The Seattle Police found a box containing two syringes. It's assumed Cobain used them to take heroin before he died. I am not sure what the size of the syringes are but I assume each have a 100 unit (1ml) capacity. It's reported that the medical examiner found fresh puncture marks on each side of Cobain's elbows.
The Seattle Police usually counter the claim that Cobain was given a lethal dose by stating that he was a heavy heroin addict who had a high drug tolerance.
In chapter 11 of the book Come As You Are, Cobain said he developed a habit of taking $400 of heroin a day in the year 1992. One source I found claims that one gram of heroin was around $167 in the 1990s. Therefore, $400 of heroin would be approximately 2.4 gram (2,400mg).
One source I found said that 200mg is the minimum lethal dose of heroin but addicts can tolerate up to ten times the amount of that.
I haven't found any information about what Cobain's daily dose in 1994 was. If he usually took two doses of heroin with the two syringes found in the box like how it was demonstrated in this video then he took 2 ml dose of heroin daily. Depending on the purity of the dose which can range from 3% to 99%, Cobain took between 60mg to 1980mg of heroin per day. If this is true then he was taking less than $400 of heroin a day. Nonetheless, his daily dosage was still high.
After incapacitating Cobain, the murderer had a time limit to kill him before the effects of heroin wore off and he was back to a normal state.
From what I have gathered it would take between 2 hours to 6 hours for the effects of the drug to wear off. Different sources give different answers as to how long the effects of heroin lasts.
Silvermist Recovery says it takes over 2 hours.
Wikipedia says it takes 4-5 hours.
The Recovery Village says that the high effects lasts for up to a couple of hours and will be followed by feelings of drowsiness and sluggishness for several hours.
American Addiction Centers says the effects can last for up to 6 hours.
In my post Countering The Cobain Case, I wrote that 225mg of heroin would take 10 to 15 hours to reduce to 1.52mg/L of morphine for Cobain. This is enough time for him to recover from the effects of heroin, write a note and shoot himself with the shotgun.
The studies done by Jerome J. Platt were done on victims of overdose. Overdose victims live a few hours before they die during which the drug in their blood would reduce in amount. In Cobain's case it is different. He didn't die from an overdose. He died from a gunshot wound in his head. Unlike the overdose victims, Cobain died in minutes from the injury. After death, his body would cease to function and stop the elimination process where the drug is transferred from his blood to the urinary bladder and the intestines. In other words, if he was murdered shortly after he was incapacitated then his body wouldn't have enough time to cleanse the drug out of his blood and he would have had a higher concentration of morphine in his blood than what was found.
It is more likely that Cobain took a heavy dose of heroin hours before he died. He had enough time to recover from the effects of the drug, write a note, shoot himself with the shotgun and end up with 1.52mg/L of morphine in his blood.
Still, I will do a rough calculation just to clear any doubts.
To do the calculations, we must know the following:
- The total estimated amount of morphine in Cobain's blood.
- The metabolism of heroin into morphine and the half-life duration of morphine.
- The estimated amount of heroin dose Cobain took.
To know how much the total amount of morphine was in Cobain's blood we need to know his blood volume. I used this online calculator to find Cobain's Estimated Blood Volume (EBV). It's assumed that Cobain weighted 135 pound around the time of his death. The EBV of a 135 pound male is about 4 litres. This means that in total, Cobain would have 6.08mg of morphine in his body. (4 x 1.52mg = 6.08mg)
2. The metabolism of heroin into morphine and the half-life duration of morphine
Cobain was found with 1.52mg/L of morphine not heroin.
Heroin gets metabolized into 6-AM very quickly in the blood. Then within a period of 5 to 30 minutes, 6-AM would metabolize into morphine.
Heroin does not convert into 6-AM only in the blood. According to one Wikipedia article, black tar heroin contains 6-AM predominantly. I found one source that explains that heroin would get hydrolyzed into 6-AM under various conditions including being in presence of alcoholic and aqueous media. This means that black tar heroin already contains 6-AM and if the heroin dose was made with water, there is a chance certain amounts of heroin in the dose got hydrolyzed into 6-AM before the dose was injected to the body and entered the blood.
The main point I am trying to make here is that there is a high chance that most of the half-life occurred with morphine, not with heroin or 6-AM.
Morphine has a half-life of 2 to 3 hours.
3. The estimated amount of heroin dose Cobain took
In the murder theory, fans usually estimate Cobain took 225mg dose of heroin.
As for the people who support the suicide verdict, they estimate that Cobain took two doses of heroin with two syringes each having 1ml max capacity. In other words, he took 2ml of heroin. Depending on the purity, a 2ml dose can contain between 60mg to 1980mg of heroin.
Now let's do the calculation.
The calculation is based on the half-life of drug. The half-life of morphine is 2 to 3 hours. Therefore, morphine takes 2 to 3 hours to reduce its amount by half.
Cobain had 1.52mg/L of morphine in his blood. In total that would be 6.08mg. After taking heroin, it quickly metabolized into morphine. Then morphine reduces by half every 2 to 3 hours until 6.08mg remains.
I do the calculations using a calculator. I divide the estimated amount of heroin Cobain took by 2. Then I divide the results I get by 2 and I do this over and over again until I get the result which is close to the estimated total amount of morphine (6.08mg).
For example
100mg ÷ 2 ÷ 2 ÷ 2 ÷ 2 = 6.25mg
6.25mg is close to 6.08mg.
I counted that I did 4 divisions. Each division is one complete half-life. Therefore, it takes 4 half-lives for 100mg to reduce close to 6.08mg. Each half-life takes 2 to 3 hours. The duration of 4 half-lives is between 8 to 12 hours. This means after taking 100mg of heroin, 8 to 12 hours later it would reduce to an amount closer to 6.08mg of morphine
Using this method I calculated that 225mg will reduce to 7.03mg in 5 half-lives. 7.03mg is closer to 6.08mg. The duration of 5 half-lives of morphine is between 10 to 15 hours.
In the suicide scenario, Cobain took 2ml dose of heroin which can contain between 60mg to 1980mg of heroin.
With 60mg it takes 3 half-lives for heroin to reduce to 6.08mg of morphine. The duration of 3 half-lives is 6 to 9 hours.
With 1980mg it takes 8 half-lives for heroin to reduce to 6.08mg of morphine. The duration of 8 half-lives is 16 to 24 hours.
It is also said that Cobain smoked some tobacco before his died and that traces of valium (diazepam) were found in his blood.
According to an article in Wikipedia on Glucuronidation, diazepam inhibits (slows down) the glucuronidation process of morphine. It also said that tobacco induces (enhances) the glucuronidation process of morphine.
The glucuronidation process metabolizes morphine into M3G and M6G and is a part of its elimination process.
In other words, it is likely the presence of diazepam and tobacco may have affected the half-life of morphine. Either it caused morphine to stay in the blood longer or it made it stay shorter.
In the murder scenario, Cobain can get murdered if he was under the influence of the drug. However, if he was murdered by being shot in the mouth with a shotgun then he would have died in a short period of time. As I said before, after death his body would cease to function and the elimination process would stop. In other words, his body would stop reducing the amount of morphine in his blood. If Cobain took 225mg of heroin as it is claimed in the murder theory then the murderer had to kill him after 10 hours at least for him to end up with 1.52mg/L of morphine in his blood. We also have to consider that the effects of heroin would end after 6 hours at most. It's unlikely that the murderer would wait for hours to kill Cobain. As a severe addict, it's unlikely that 225mg of heroin would work on him and incapacitate him. He would require more than that. The more heroin he would take, the more time it will take for the drug to reduce in amount.
In the suicide scenario, Cobain took two shots of 1ml doses of heroin. Depending on its purity level, the dose contained between 60mg to 1980mg of heroin. It would take a minimum of 6 hours to maximum 24 hours for the drug to reduce to 1.52mg/L of morphine in his blood. Cobain didn't kill himself immediately after taking heroin. It's more likely that he killed himself hours after he took heroin. He had enough time to recover from the effects of heroin and write down a note before he killed himself.
Regarding the traces of diazepam found in Cobain's blood, I do not know what the exact traces they found. Diazepam has a long half-life of about 48 to 50 hours. It has several metabolites and a few of them have very long half-life like up to 100 hours or 200 hours. This means that diazepam can stay in the blood for 10 days and its metabolites can stay in the blood for over a month. It's likely Cobain took diazepam days before he died.
A can of beer was also found at the scene. It's assumed Cobain drank some beer before he died.
In the book Love and Death a coroner named Denise Marshall alleges that the murderer added diazepam in the beer and gave it to Cobain with heroin so that he would get incapacitated faster.
According to the 2014 police report by Mike Ciesynski, Cobain's Blood Ethanol (alcohol) was negative. To view the police report, you will have to open or download the pdf file. I originally found the report from a blog called Nirvana Legacy. You can find the police report there as well.
From what I have researched, after drinking alcohol, it stays in the blood for up to 6 hours. Another source says that it stays for up to 12 hours. If Cobain had drank beer before his death and his blood alcohol report came negative, that means that he drank beer hours before he died. At most 12 hours. As for diazepam, if trace amounts were found, it is likely that Cobain took the drug days before he died. He did not take diazepam along with heroin.
Conclusion
1.52mg per litre of morphine in blood does not indicate that Cobain was given a lethal dose. 225mg of heroin is unlikely to incapacitate a severe addict. Heroin metabolizes into morphine. It takes time for morphine to reduce in amount in the blood. It's likely Cobain took heroin hours before he killed himself. A drug kit was found with two syringes assumed to be 100 units each. A 100 unit syringe is equal to the value of 1ml. 1ml is equal to 1000mg. It's assumed Cobain took two doses containing between 60mg to 1980mg of heroin which within a period of 6 hours to 24 hours was reduced to 1.52mg/L of morphine in his blood. The traces of valium (diazepam) found in the blood was likely from a drug use done days before Cobain died. Cobain's blood ethanol was negative. Alcohol takes up to 6 to 12 hours to leave the blood. It is likely Cobain drank beer several hours before he died. He died from a self-inflicted gunshot wound inside his head by shooting the shotgun in his mouth.
-Indya
Update - 14/3/23
There's a new section on Wikipedia article on Cobain's death called Toxicological Ambiguities. According to this, there are two types of tests to evaluate morphine levels in blood sample - total morphine and free morphine. Total morphine involves a basic test which includes not only morphine but its metabolites. Free morphine involves a specialized test which involves only those morphine that haven't been broken down into its metabolites form. According to the article, 1.52mg/L of total morphine in blood have been proven to be survivable. However, free morphine count of 0.12mg/L is fatal. Free morphine tests require special equipment and expertise and must be performed soon after the body dies in order for the results to be accurate whereas total morphine is commonly performed in law enforcements because it provides a better indicator of intoxication and impairment.
We do not know whether the toxicology report of Cobain tested his morphine level using the total morphine method or the free morphine method. If the test result was from a free morphine test then there's doubt that Cobain died from an overdose. For those of you who are in doubt that he was murdered and are attempting to reopen the case, I suggest you to find out what test was done to evaluate the morphine levels - total morphine or free morphine. You may be able to reopen the case if you find out that they used free morphine test to evaluate the morphine level in Cobain's blood.
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