News (Media Awareness Project) - US MI: Lethal Cocktail: The Tragedy And Aftermath -Part 1 of 2 |
Title: | US MI: Lethal Cocktail: The Tragedy And Aftermath -Part 1 of 2 |
Published On: | 1999-12-05 |
Source: | Detroit News (MI) |
Fetched On: | 2008-09-05 13:39:46 |
Pubdate: Sun, 5 Dec 1999
Source: Detroit News (MI)
Copyright: 1999, The Detroit News
Contact: letters@detnews.com
Feedback: http://data.detnews.com:8081/feedback/
Website: http://www.detnews.com/
Author: Jodi S. Cohen, The Detroit News
Note: This is part 1 of a two-part report and includes four sidebar
articles, below, titled: MANY FLIRT WITH GHB, UNMINDFUL OF RISKS; COMMON
QUESTIONS ABOUT GHB AND GBL; HOW TO GET INFORMATION; and IF YOU'RE DRUGGED.
Part 2 is at:
http://www.mapinc.org/drugnews/v99.n1333.a01.html
LETHAL COCKTAIL: THE TRAGEDY AND THE AFTERMATH
The streets were alive with teen-agers looking for a Saturday night hangout.
As usual, they complained there was nothing to do in their factory towns on
the southern outskirts of Detroit.
It was Jan. 16 and ice covered the sidewalks. In one blue van, a group of
five teens were doing nothing, as they say, just feeling the freedom of
driving around on a Saturday night.
The high school students stopped for cigarettes at a Total gas station, got
a peach Slurpee at 7-Eleven, smoked a marijuana joint and ate some burgers
at McDonald's. Nights like this had become routine for the two senior boys
in the car, but it was a thrill for the three freshman girls
in the back seat.
But by early morning, two girls in the group - best friends Samantha Reid
and Melanie Sindone - were lying unconscious next to each other on the cold
tile of a stranger's bathroom.
Not too long before, Samantha and Melanie had sat in drug-education classes
at Carlson High School in Gibraltar. They had learned about marijuana,
heroin, cocaine and alcohol.
But teachers never mentioned a scientific-sounding drug called gamma
hydroxybutyrate. The girls never learned there was a clear liquid known on
the streets as G or Scoop or GHB.
Nobody told them to watch their glasses at parties. Nobody told them that if
a drink tastes salty when it shouldn't, stop drinking it.
For Melanie, 15, the January night is mostly a blur. She remembers what it
felt like as her body slowly went numb while she watched her friend slump
down into a couch.
"I couldn't help her," Melanie said.
Nobody could. At 7:36 p.m. the following day, Samantha Reid would be dead.
For months, even years in some regions of the country, GHB had been putting
body-builders and teen partiers into comas.
At least 46 deaths nationwide and more than 5,500 overdoses have been linked
to GHB since 1995, including at least two deaths in Michigan, said Trinka
Porrata, a retired Los Angeles Police Department detective and the nation's
leading GHB authority. The drug is colorless and odorless with a slightly
salty taste. There is a small difference between a dose that will get
someone high and one that will kill. The drug is often mixed at home by
teens who unknowingly can put together a deadly substance.
"The risk of dying is so volatile and unpredictable. One time - and you
might be dead as a doornail," Porrata said. "It is the most dangerous drug I
have dealt with in 25 years."
The statistics dating back to 1995 are understated, she said, mostly because
law enforcement officials and medical examiners weren't paying attention to
a drug they thought was affecting only a few groups of people known to take
risks, such as body builders.
But Samantha and Melanie weren't body builders or participants in all-night
parties known as raves. For that reason, the drugging of these two young
girls would bring national attention to a new alphabet of drugs: E for
Ecstasy, K for Ketamine and G for GHB.
The story of Samantha Reid and Melanie Sindone would show that anybody can
become a victim of this new drug culture, one promoted as "natural and safe"
by underground manufacturers and traded in basements and over the Internet.
It would make some teens cautious about where they party and frighten
parents about what could happen to even the most innocent children. It would
spark debate in Washington about putting strict penalties on the use of the
easily available drugs.
It would lead to the nation's first prosecution for a GHB-related homicide.
Still, since Samantha's death in January, the GHB statistics have continued
to grow. At least 10 more people have died from this drug and another 40
deaths are being investigated by the U.S. Drug Enforcement Administration.
It was Jan. 14, 1999, and Joshua Cole, now 19, and Erick Limmer, now 26,
were drinking at BT's Lounge, a strip club on Michigan Avenue in Dearborn.
After the dancers finished, Josh and Erick met a third man at a gas station
across the street from the bar. The man reached into the trunk of his car
and took out a clear gallon container of what authorities believe was either
GHB or a close chemical substitute called GBL. He unwound the bubble wrap
from the glass container. Erick bought the drug and took it to his apartment
on Grosse Ile.
Erick told Josh not to touch it, according to statements Josh later gave to
police.
Last January, about the same time Erick and Josh bought the drug, Samantha
and Melanie were at Samantha's house in Rockwood, watching Teletubbies.
They ordered in cheesy bread from Benito's Pizza and passed a two-liter
Mountain Dew back and forth between them. They listened to hip-hop, the
Dixie Chicks and Monifah's Touch It. They talked about taking drivers'
education classes together, going on a spring-break trip to Daytona Beach,
Fla., and their latest crushes.
They used magic markers to write messages on the walls of Samantha's
bedroom. Her mother planned to paint the room and allowed Samantha and her
friends to graffiti the walls.
"Love you like a sis," Melanie wrote to Samantha. "Best friends forever."
Samantha and Melanie met in middle school, but they didn't become friends
until the beginning of their freshman year in high school. They quickly
became inseparable. After school, Melanie often took the bus home to
Samantha's house, where she would stay over three or four nights a week.
Soon, the same three charms hung from their necks:
Best Friends.
365.
24-7.
Samantha was Melanie's motivator. Samantha loved having fun and couldn't
stand to see someone pouting. "Melanie SinDONE," she would say, accenting
the last part of her name. "Get up. Have fun."
They both played loud music. Both had divorced parents. Both turned 15 in
January.
They had differences, too.
Samantha craved attention and earned the nickname Hammy Sammy because she
jumped in front of a camera at every opportunity. Melanie was always the
quieter one who shied away from the spotlight.
Samantha, who stood 5 feet 4 inches and weighed 122 pounds, played every
sport she could, including basketball, baseball and gymnastics. Melanie, a
tiny girl at just 5 feet and about 95 pounds, planned to play basketball her
freshman year, but she was hurt before the season started.
Both girls lived with their mothers after their parents divorced, and both
moved around before their freshman year. Melanie's family stayed in the
Downriver area; Samantha's mother, Judi Clark, 38, moved her daughter and
son from Detroit to Lincoln Park to Rockwood.
After Samantha's father left when she was two years old, her mother moved
Samantha and her older brother, Charles, to a home in southwest Detroit.
But Judi, a strong-spirited mother, got into a pipe-fitter's apprenticeship
program, and when she could afford it a few years later, she moved her
family to Lincoln Park. Two years after that, when she could afford to move
again, she bought a house in Rockwood to be in a safer neighborhood.
As a pipe-fitter, Judi did hard, dirty work for Great Lakes Steel Blast
Furnace last winter, crawling into tunnels to reline furnaces. She worked 10
hours a day so Samantha could have the things teens want: Nike T-shirts,
glitter make-up, money for the movies and, hopefully, a trip to Disney
World.
Samantha was always eager to make others happy, especially her mother. Even
as a freshman, when it's no longer cool to call her mother "mommy," she did
it anyway.
"She's the same girl that everyone else is raising. She's the Girl Scout and
the basketball player and the baseball player and the girl who likes the
drive-through at McDonald's," said her mother, Judi. "She's the girl who
looked forward to driving and getting a job."
Samantha and her mother had a deal: Judi would work long hours to support
them, and Samantha would keep the house and yard tidy. Melanie sometimes
helped Samantha with her chores.
When Samantha wasn't doing chores, one of her greatest passions was writing
poetry.
She wrote about everything. About boyfriends, best friends and peer
pressure.
She also wrote a poem about her fear of dying. In that poem, Samantha wrote:
"What if I am too young still/Not old enough to die? What if I want to wait
until/I've experienced life to say goodbye?"
Samantha didn't get that chance. On Jan.16, she said goodbye to her mom and
got into a friend's van.
They drove to Grosse Ile, a community sheltered by the waters of the Detroit
River.
A sign at the island's police station told visitors that it was "Michigan's
safest community."
"What should I wear?" Samantha asked Melanie.
She had already changed a few times. Clothes were scattered on her bed and
the floor. Lipstick and eye-shadow were strewn across her vanity.
It was Saturday night, and the girls were getting ready to hang out with two
seniors from their high school, Daniel Brayman and Nicholas Holtschlag, both
18. Melanie's stepsister, Jessica VanWassehnova, also a ninth-grader, went
along.
Samantha almost didn't make it out. Her mom had grounded her so her grades
would improve. But Samantha had been upset about trouble in a relationship
with her boyfriend. Her mom decided to let her go out, rationalizing that
mingling with friends might get her mind off the problem.
About 8:30 p.m., there was a knock at the door and Nick came inside.
Samantha told her mom she was going to see a movie and said she would be
home before her 1 a.m. curfew. Melanie, who was planning to spend the night
at Samantha's house, never called her mom to let her know she was going out.
The three girls got into the back of Nick's van, and they hit the road with
no place to go. Dan was already sitting in the front. They drove around for
about two to three hours. Nobody mentioned the movie.
They stopped at a Total gas station to get cigarettes and then went to the
Marina Bay apartments in Gibraltar. In the parking lot of the apartment
complex, a man walked up to the van and traded a bag of marijuana for cash.
They drove through Downriver as they passed a joint, the smell of marijuana
mixed with the taste of rebellion. It's unclear whether Samantha smoked it.
Melanie and Samantha went inside a 7-Eleven in Brownstown Township to get a
peach Slurpee and then stopped at a McDonald's. Meanwhile, Nick picked up
his cell phone and punched in a number. The phone rang at an apartment on
Grosse Ile.
Nick told the person on the other end that the group was on its way over and
to get alcohol, Melanie and Jessica recall.
Nick hung up and drove south toward the Detroit River. He crossed over the
bumpy bridge to Grosse Ile and entered a different lifestyle. Grosse Ile is
home to lakefront mansions, three yacht clubs and horse stables. There are
no movie theaters or fast-food joints that dot every other Downriver town.
When they got inside Apartment 34 in the Elbamar Apartment complex on Groh
Road, the girls flopped down on a couch. It was about 11 p.m.
There were no parents there, just the three girls, Nick, Dan and another
friend whom the girls didn't know, Joshua Cole. Their host was Erick Limmer.
They turned on Saturday Night Live. Teen heartthrob James Van Der Beek,
better known as Dawson on the WB show Dawson's Creek, was the guest host.
Melanie took a few sips of a Budweiser and put it down because she didn't
like it. She declined another drink from Josh.
Erick walked into the living room. He threw a baggie of marijuana on the
table and Nick rolled a joint, Melanie said. They watched Jackie Brown, a
crime story about regular people who break the law from time to time.
Melanie poured herself two shots of Apple Pucker liquor mixed with vodka.
The teens were bored, and Josh started to get antsy. Erick left the room to
take a shower.
"Let's play drinking games," Josh said, bringing out a deck of cards.
"No," everyone else replied.
"Do you want something else to drink?" the girls recall Josh asking.
Melanie said she wanted a screwdriver, a mix of vodka and orange juice, and
Samantha said she wanted a Mountain Dew. Josh, Nick and Dan went into the
kitchen. They talked and passed around another joint, Melanie said. Josh
made the girls their drinks.
Josh would later tell police that he wanted the girls to talk more, to act
more lively. He wondered if some of that stuff Erick bought at the strip
club, put into the girls' drinks, would liven up the party.
Dan handed a drink to Melanie, and Nick handed a drink to Samantha, Melanie
said. They were watching Superfly on video, a 1972 movie about a coke dealer
wanting to make one last big score before going clean.
Melanie and Samantha sipped their drinks.
"This tastes gross," Samantha said to her friend. "Can you try it?"
Melanie took a small sip, agreed that it tasted gross and handed it back to
Samantha, who quickly gulped down almost the whole glass of Mountain Dew.
She didn't know it, but she also swallowed GBL, the main ingredient of GHB.
The chemical contains the same ingredients found in floor stripper and drain
cleaner.
Within a few minutes, Samantha passed out on the couch. Melanie sipped the
screwdriver and rapidly felt drunk. She felt her body going numb and tried
to stop it.
Melanie began to vomit. Jessica and at least one of the boys carried her
into the bathroom, where she continued to throw up. After she stopped
vomiting, her friends laid her on her side on a towel in the bathroom "so
she didn't choke," Jessica said.
It was about 2 a.m., and Samantha was still sleeping on the living-room
couch as the rest of the group continued to watch TV. Erick was mad about
the vomit on his carpet and furniture and told the teens to scrub the
cushions and vacuum the carpet.
Then, they heard Samantha gagging and throwing up in her sleep. The other
teens carried her into the bathroom and laid her next to Melanie, two best
friends again sleeping side by side.
If they had taken Samantha to the hospital, she likely would be alive today,
doctors would later say.
Instead, Samantha continued to vomit while she was unconscious.
Vomit went into Samantha's right lung, doctors would later discover. Soon,
the vomit would block air trying to reach her lungs.
The other four teens knew the girls didn't look good, but they didn't think
anything really bad could happen. So they left them there to sleep it off.
While the two girls slept, Nick and Dan drove to Meijer at 3:15 a.m. and
bought carpet cleaner and a $69.99 Hoover vacuum to clean the girls' vomit
from Erick's apartment.
As they put the vacuum together, the teens heard a gagging noise coming from
the bathroom.
Samantha was making "noises and having problems breathing," Jessica
recalled. She checked for a pulse and wasn't sure if she had one. Jessica
and the other boys discussed calling an ambulance.
"No," said Erick, worried about authorities coming to his house. About 4:30
a.m., six teens piled back into Nick's van. Josh carried Samantha, dropping
her on the ice-covered sidewalk as he slipped on his way to the van.
Erick's parting advice: Don't tell anyone you were here.
On the way to the hospital, Jessica saw "white stuff stuck in (Samantha's)
throat" and stuck her fingers in her mouth to try to clear it away.
Melanie, meanwhile, was "breathing funny," Jessica recalled. The girls were
carried into Oakwood Hospital-Seaway Center in Trenton at 4:45 a.m.
Neither girl was breathing.
Neither girl had a heart beat.
"You don't know me, but my name is Josh and I met Melanie tonight and she
got so drunk and passed out and we took her to the hospital."
Those are the words Nancy Sindone remembers waking up to when her telephone
rang about 4:45 a.m. Jan. 17.
A few minutes later, the phone startled another mother, Judi Clark, who had
fallen asleep on the couch. Joshua Cole, a boy she had never met, was on the
line.
He started to give her the same news when the call-waiting beep interrupted
him. It was the emergency room staff.
"Is she there because of alcohol poisoning?" Judi asked the nurse. She knew
there had been a lot of that going on at colleges.
"No," he told her. He didn't tell her it was much worse: The two girls were
unconscious, but they didn't reek of alcohol. Doctors suspected GHB, a
powerful depressant they had learned about at a recent conference.
They had no way to test for GHB, so they treated the girls the same way they
would treat any unconscious patient.
Minutes later, both mothers drove through dense fog to the emergency room.
It was the beginning of a daylong vigil at their daughters' bedsides.
During the first few hours at the hospital, the girls looked identical:
Stark white, eyes shut, tubes stuck up their noses and down their throats.
Hospital gowns replaced jeans.
"They looked dead," Nancy Sindone recalled.
Melanie was breathing slowly and was put on a respirator. Unlike Samantha,
vomit had not reached her lungs. If Melanie had been brought to the hospital
a few minutes later, she likely would have stopped breathing, had a heart
attack and died, doctors said.
Her deterioration was just steps behind Samantha's. Doctors said Samantha
was in such severe shock when she got to the hospital that she was
essentially dead.
"You're wrong," Judi told the doctors. "I have a tough girl there, and she's
going to make it."
Doctors didn't know why Samantha was in a coma. There was no external trauma
and no sign of alcohol ingestion. They mentioned something called GHB, but
said they weren't sure if that was what put her into a coma.
They had no way to know for sure. Oakwood Hospital-Seaway Center, like all
the other hospitals in Michigan, has no way to test for GHB. In some ways, a
test would be irrelevant: There is no antidote for GHB. And because it
generally leaves the body within 12 hours, it may already be undetectable
when a victim gets to the hospital.
Doctors wanted Judi to see her daughter right away. They feared that she
wouldn't live much longer.
Judi tried to go to her daughter's bed, but couldn't. She called her mother
and boyfriend. She couldn't go back there alone, couldn't see her
15-year-old daughter strapped to life support.
Samantha's boyfriend, aunts, and cousins came to the hospital to support
Judi and tell Samantha that they loved her.
About 5 p.m., Judi went home to get clothes so she could spend the night at
the hospital. When she returned, Samantha's bed was tilted and her feet were
sticking up in the air.
The doctor asked Judi to leave the room. Samantha's heart had stopped
beating twice, and it was becoming harder to get it started again. Her
kidneys and liver had already shut down, her blood pressure kept dropping
and her heart overworked itself trying to compensate for the failed organs.
The doctor came out to the waiting room a half hour later. "How many times
do you want to let your daughter die?" he asked Judi.
Judi never answered the question.
Melanie opened her eyes about 17 hours after she closed them on Grosse Ile.
She gagged from the tube that went down her throat and into her lungs to
help her breathe. Her arms were strapped to the bed.
Her eyes were open, but the tube lodged in her throat kept her from asking
where she was and why she was there. Instead, she scribbled short phrases on
scrap paper.
Where am I?
What happened?
Where's Sammy?
Doctors told her that Samantha was in the next room. They mentioned GHB.
Melanie had never heard of it before.
She wanted to see Samantha. Doctors advised against it, but then reluctantly
wheeled her bulky hospital bed to the window of the room next door.
Hours ago, they were lying unconscious on a bathroom floor. Now, Melanie was
looking at Samantha through a window, the closest she could get to her best
friend. She turned to Samantha's mother, Judi, whose face was puffy from a
day of crying. She had to say something. "I'll come clean the house for
you," she told Samantha's mom.
Judi heard what Melanie said, but she didn't know how to respond.
They looked at each other, looked through the window into Samantha's room,
and looked back at each other.
In the silence, tears rolled down their faces.
"I'll clean your house," Melanie said again.
Judi nodded. They both knew that Samantha would never do the household
chores again.
[First Sidebar]
MANY FLIRT WITH GHB, UNMINDFUL OF RISKS
It Attracts Those Who Would Never Touch 'Real Drugs'
A 22-year-old man from Trenton puts five capfuls of GHB into Kool-Aid,
guzzles the drink and passes out within minutes. He has a seizure at home
while waiting for an ambulance.
A 23-year-old man from Grosse Pointe drinks GHB, gamma hydroxybutyrate, from
an Evian bottle at a bar. He begins twitching and has stopped breathing by
the time he gets to a hospital.
A Detroit man, 30, has been using GHB for two months for body building and
euphoria. He bought it from a friend and now can't go more than a few hours
without it. He calls the Poison Control Center in Detroit, wanting to know
about treatment programs for addiction.
A 17-year-old man from Pontiac bought GHB over the Internet. He drinks some
of it, begins vomiting and lapses into a coma. He wakes up in the hospital
four hours later.
This is the world of GHB, a drug gaining popularity in Michigan and
throughout the nation. Although it is best known as a "date-rape" drug, more
than 80 percent of overdose cases are from people who willingly use the
drug. The majority are white men, ages 17 to 30.
Teens and young adults use it to get high without drinking alcohol or
combine the two drugs in a lethal cocktail to intensify a buzz. Body
builders think it will make them stronger.
The recreational users of GHB often buy the chemicals on the Internet and
mix them at home. Unlike illegal drugs that are manufactured in controlled
laboratories, this "kitchen sink" chemistry means there is little regard for
accurate proportions or quality control.
As a result, there are unpredictable - and sometimes deadly - reactions like
those experienced by callers to the Poison Control Center this year. Many of
the calls come from doctors and nurses seeking advice about a possible GHB
victim. The center already has received more than four times the number of
GHB-related calls this year than it did four years ago.
GHB is colorless and odorless with a slightly salty taste. Because it is a
clear liquid, it easily can be masked in other drinks such as water, soda or
juice. There are cases where teens drank "water" from sports bottles, but
really had mixed GHB into the liquid. Their parents or coaches had no idea.
Because only a few drops can get someone high, the drug can be carried in
innocent-looking containers such as Visine eye-drop dispensers.
The drug is attracting people who say they would never touch "real drugs"
such as cocaine and heroin, but want a drug that will relax them like
alcohol.
But because there is a small difference between a dose that will get someone
high and one that will kill, some users find themselves waking up in an
emergency room.
"There is no safe level of use. Nobody can tell you what is a safe level,"
said Trinka Porrata, a drug consultant and former Los Angeles Police
Department detective. "A drop may be too much. A dose that might make a
150-pound woman high can kill a 300-pound man. It's unpredictable."
Dr. Susan Smolinske of the Poison Control Center said more calls lately have
come from people using GHB alternatives, products that act like GHB but
instead contain a related substance that usually is legal. Those products
are sold on the Internet with benign names like Renewtrient, Zen and Blue
Nitro.
The U.S. Drug Enforcement Administration estimates that at least 46 people
have died and 5,500 others have overdosed since 1995. They are investigating
at least 40 more suspected GHB deaths this year.
"It is not some little cult of lost kids who are doing this drug," Porrata
said. "These are the mainstream kids who are using it and dying from it."
[Second Sidebar]
COMMON QUESTIONS ABOUT GHB AND GBL
Q: What are GHB and GBL?
A: GHB and its legal cousin, GBL, were initially sold in health food stores
and used by body builders, who thought the chemicals would stimulate muscle
growth. Both drugs slow down the central nervous system. Once GBL is
ingested, it metabolizes into GHB.
Q: What are the street names for GHB?
A: G, Scoop, Liquid Ecstasy, Georgia Home Boy, Grievous Bodily Harm, Liquid
X, Easy Lay.
Q: What are some products that contain GHB or GBL and are available on the
Internet?
A: Blue Nitro, Revivarant, Renewtrient, Revitalize Plus, Serenity, Enliven,
SomatoPro, Invigorate, Midnight Blue and Zen.
Q: Who is using GHB and GBL?
A: It is usually taken at parties, clubs or raves. It is found at gyms, and
it has been used as a date-rape drug because it is odorless, colorless and
virtually tasteless. It does have a salty taste, however.
Q: What are the effects of GHB and GBL use?
A: It is said to mimic alcohol consumption, producing euphoria in the user.
In larger doses, it can put someone to sleep. In dangerously high doses, it
can induce nausea, vomiting, seizures and coma.
Q: Is GHB legal?
A: In Michigan, GHB is a Schedule I drug, in the same category as heroin or
cocaine. Convictions for making the drug can bring up to seven years in
prison. Possessing the drug can bring a two-year prison sentence. Use can
result in one year in jail.
There is no federal penalty for the drug, but the U.S. House and Senate
recently passed legislation that would put it in the Schedule I category,
making use and manufacture of it illegal except for medical testing. The
bill awaits approval by President Clinton.
The FDA banned over-the-counter sales in 1990.
Sources: The Maryland Drug Early Warning System and
http://www.ashesonthesea.com/ghb
[Third Sidebar]
HOW TO GET INFORMATION
To contribute to the Samantha Reid Fund, write to:
The Samantha Reid Fund
P.O. Box 119
Rockwood, MI 48173
For Information About GHB And Related Substances:
1-800-POISON1
www.ashesonthesea.com/ghb
www.health.org/pubs/qdocs/depress/ghb/frame.htm
www.quackwatch.com/01QuackeryRelatedTopics/ghb.html
www.drugfreeamerica.org/ghb_ne.html
www.fda.gov
www.clubdrugs.org
Overdoses And Sexual Assaults:
If you or a friend has overdosed, call 9-1-1 immediately. If you have been
sexually assaulted, call police or a 24-hour crises enter.
Detroit Rape Counseling Center: (313) 833-1660.
First Step, in western Wayne County: (888) 453-5900.
HAVEN, in Oakland County: (248) 334-1274.
Turning Point, in Macomb County: (810) 463-6990.
[Fourth Sidebar]
IF YOU'RE DRUGGED
Try to save a sample of your drink.
If you need medical care, call an ambulance.
Have a physician test for the drug, which typically leaves the body within
12 hours.
Protect Yourself
Keep an eye on your glass. Don't accept a drink from someone you don't know
or don't trust.
Only accept drinks at a bar or a club from a staff server.
Use the buddy system. Watch the behavior of friends.
Don't drink from a punch bowl or other common source.
Damage drug can do
GHB, taken alone or in combination with other drugs, can depress the central
nervous system.
That has many potential serious side effects, including:
Coma
Seizures
Anxiety
Tremors
Dizziness
Nausea
Vomiting
Confusion
Hallucinations
Respiratory arrest
Source: Detroit News (MI)
Copyright: 1999, The Detroit News
Contact: letters@detnews.com
Feedback: http://data.detnews.com:8081/feedback/
Website: http://www.detnews.com/
Author: Jodi S. Cohen, The Detroit News
Note: This is part 1 of a two-part report and includes four sidebar
articles, below, titled: MANY FLIRT WITH GHB, UNMINDFUL OF RISKS; COMMON
QUESTIONS ABOUT GHB AND GBL; HOW TO GET INFORMATION; and IF YOU'RE DRUGGED.
Part 2 is at:
http://www.mapinc.org/drugnews/v99.n1333.a01.html
LETHAL COCKTAIL: THE TRAGEDY AND THE AFTERMATH
The streets were alive with teen-agers looking for a Saturday night hangout.
As usual, they complained there was nothing to do in their factory towns on
the southern outskirts of Detroit.
It was Jan. 16 and ice covered the sidewalks. In one blue van, a group of
five teens were doing nothing, as they say, just feeling the freedom of
driving around on a Saturday night.
The high school students stopped for cigarettes at a Total gas station, got
a peach Slurpee at 7-Eleven, smoked a marijuana joint and ate some burgers
at McDonald's. Nights like this had become routine for the two senior boys
in the car, but it was a thrill for the three freshman girls
in the back seat.
But by early morning, two girls in the group - best friends Samantha Reid
and Melanie Sindone - were lying unconscious next to each other on the cold
tile of a stranger's bathroom.
Not too long before, Samantha and Melanie had sat in drug-education classes
at Carlson High School in Gibraltar. They had learned about marijuana,
heroin, cocaine and alcohol.
But teachers never mentioned a scientific-sounding drug called gamma
hydroxybutyrate. The girls never learned there was a clear liquid known on
the streets as G or Scoop or GHB.
Nobody told them to watch their glasses at parties. Nobody told them that if
a drink tastes salty when it shouldn't, stop drinking it.
For Melanie, 15, the January night is mostly a blur. She remembers what it
felt like as her body slowly went numb while she watched her friend slump
down into a couch.
"I couldn't help her," Melanie said.
Nobody could. At 7:36 p.m. the following day, Samantha Reid would be dead.
For months, even years in some regions of the country, GHB had been putting
body-builders and teen partiers into comas.
At least 46 deaths nationwide and more than 5,500 overdoses have been linked
to GHB since 1995, including at least two deaths in Michigan, said Trinka
Porrata, a retired Los Angeles Police Department detective and the nation's
leading GHB authority. The drug is colorless and odorless with a slightly
salty taste. There is a small difference between a dose that will get
someone high and one that will kill. The drug is often mixed at home by
teens who unknowingly can put together a deadly substance.
"The risk of dying is so volatile and unpredictable. One time - and you
might be dead as a doornail," Porrata said. "It is the most dangerous drug I
have dealt with in 25 years."
The statistics dating back to 1995 are understated, she said, mostly because
law enforcement officials and medical examiners weren't paying attention to
a drug they thought was affecting only a few groups of people known to take
risks, such as body builders.
But Samantha and Melanie weren't body builders or participants in all-night
parties known as raves. For that reason, the drugging of these two young
girls would bring national attention to a new alphabet of drugs: E for
Ecstasy, K for Ketamine and G for GHB.
The story of Samantha Reid and Melanie Sindone would show that anybody can
become a victim of this new drug culture, one promoted as "natural and safe"
by underground manufacturers and traded in basements and over the Internet.
It would make some teens cautious about where they party and frighten
parents about what could happen to even the most innocent children. It would
spark debate in Washington about putting strict penalties on the use of the
easily available drugs.
It would lead to the nation's first prosecution for a GHB-related homicide.
Still, since Samantha's death in January, the GHB statistics have continued
to grow. At least 10 more people have died from this drug and another 40
deaths are being investigated by the U.S. Drug Enforcement Administration.
It was Jan. 14, 1999, and Joshua Cole, now 19, and Erick Limmer, now 26,
were drinking at BT's Lounge, a strip club on Michigan Avenue in Dearborn.
After the dancers finished, Josh and Erick met a third man at a gas station
across the street from the bar. The man reached into the trunk of his car
and took out a clear gallon container of what authorities believe was either
GHB or a close chemical substitute called GBL. He unwound the bubble wrap
from the glass container. Erick bought the drug and took it to his apartment
on Grosse Ile.
Erick told Josh not to touch it, according to statements Josh later gave to
police.
Last January, about the same time Erick and Josh bought the drug, Samantha
and Melanie were at Samantha's house in Rockwood, watching Teletubbies.
They ordered in cheesy bread from Benito's Pizza and passed a two-liter
Mountain Dew back and forth between them. They listened to hip-hop, the
Dixie Chicks and Monifah's Touch It. They talked about taking drivers'
education classes together, going on a spring-break trip to Daytona Beach,
Fla., and their latest crushes.
They used magic markers to write messages on the walls of Samantha's
bedroom. Her mother planned to paint the room and allowed Samantha and her
friends to graffiti the walls.
"Love you like a sis," Melanie wrote to Samantha. "Best friends forever."
Samantha and Melanie met in middle school, but they didn't become friends
until the beginning of their freshman year in high school. They quickly
became inseparable. After school, Melanie often took the bus home to
Samantha's house, where she would stay over three or four nights a week.
Soon, the same three charms hung from their necks:
Best Friends.
365.
24-7.
Samantha was Melanie's motivator. Samantha loved having fun and couldn't
stand to see someone pouting. "Melanie SinDONE," she would say, accenting
the last part of her name. "Get up. Have fun."
They both played loud music. Both had divorced parents. Both turned 15 in
January.
They had differences, too.
Samantha craved attention and earned the nickname Hammy Sammy because she
jumped in front of a camera at every opportunity. Melanie was always the
quieter one who shied away from the spotlight.
Samantha, who stood 5 feet 4 inches and weighed 122 pounds, played every
sport she could, including basketball, baseball and gymnastics. Melanie, a
tiny girl at just 5 feet and about 95 pounds, planned to play basketball her
freshman year, but she was hurt before the season started.
Both girls lived with their mothers after their parents divorced, and both
moved around before their freshman year. Melanie's family stayed in the
Downriver area; Samantha's mother, Judi Clark, 38, moved her daughter and
son from Detroit to Lincoln Park to Rockwood.
After Samantha's father left when she was two years old, her mother moved
Samantha and her older brother, Charles, to a home in southwest Detroit.
But Judi, a strong-spirited mother, got into a pipe-fitter's apprenticeship
program, and when she could afford it a few years later, she moved her
family to Lincoln Park. Two years after that, when she could afford to move
again, she bought a house in Rockwood to be in a safer neighborhood.
As a pipe-fitter, Judi did hard, dirty work for Great Lakes Steel Blast
Furnace last winter, crawling into tunnels to reline furnaces. She worked 10
hours a day so Samantha could have the things teens want: Nike T-shirts,
glitter make-up, money for the movies and, hopefully, a trip to Disney
World.
Samantha was always eager to make others happy, especially her mother. Even
as a freshman, when it's no longer cool to call her mother "mommy," she did
it anyway.
"She's the same girl that everyone else is raising. She's the Girl Scout and
the basketball player and the baseball player and the girl who likes the
drive-through at McDonald's," said her mother, Judi. "She's the girl who
looked forward to driving and getting a job."
Samantha and her mother had a deal: Judi would work long hours to support
them, and Samantha would keep the house and yard tidy. Melanie sometimes
helped Samantha with her chores.
When Samantha wasn't doing chores, one of her greatest passions was writing
poetry.
She wrote about everything. About boyfriends, best friends and peer
pressure.
She also wrote a poem about her fear of dying. In that poem, Samantha wrote:
"What if I am too young still/Not old enough to die? What if I want to wait
until/I've experienced life to say goodbye?"
Samantha didn't get that chance. On Jan.16, she said goodbye to her mom and
got into a friend's van.
They drove to Grosse Ile, a community sheltered by the waters of the Detroit
River.
A sign at the island's police station told visitors that it was "Michigan's
safest community."
"What should I wear?" Samantha asked Melanie.
She had already changed a few times. Clothes were scattered on her bed and
the floor. Lipstick and eye-shadow were strewn across her vanity.
It was Saturday night, and the girls were getting ready to hang out with two
seniors from their high school, Daniel Brayman and Nicholas Holtschlag, both
18. Melanie's stepsister, Jessica VanWassehnova, also a ninth-grader, went
along.
Samantha almost didn't make it out. Her mom had grounded her so her grades
would improve. But Samantha had been upset about trouble in a relationship
with her boyfriend. Her mom decided to let her go out, rationalizing that
mingling with friends might get her mind off the problem.
About 8:30 p.m., there was a knock at the door and Nick came inside.
Samantha told her mom she was going to see a movie and said she would be
home before her 1 a.m. curfew. Melanie, who was planning to spend the night
at Samantha's house, never called her mom to let her know she was going out.
The three girls got into the back of Nick's van, and they hit the road with
no place to go. Dan was already sitting in the front. They drove around for
about two to three hours. Nobody mentioned the movie.
They stopped at a Total gas station to get cigarettes and then went to the
Marina Bay apartments in Gibraltar. In the parking lot of the apartment
complex, a man walked up to the van and traded a bag of marijuana for cash.
They drove through Downriver as they passed a joint, the smell of marijuana
mixed with the taste of rebellion. It's unclear whether Samantha smoked it.
Melanie and Samantha went inside a 7-Eleven in Brownstown Township to get a
peach Slurpee and then stopped at a McDonald's. Meanwhile, Nick picked up
his cell phone and punched in a number. The phone rang at an apartment on
Grosse Ile.
Nick told the person on the other end that the group was on its way over and
to get alcohol, Melanie and Jessica recall.
Nick hung up and drove south toward the Detroit River. He crossed over the
bumpy bridge to Grosse Ile and entered a different lifestyle. Grosse Ile is
home to lakefront mansions, three yacht clubs and horse stables. There are
no movie theaters or fast-food joints that dot every other Downriver town.
When they got inside Apartment 34 in the Elbamar Apartment complex on Groh
Road, the girls flopped down on a couch. It was about 11 p.m.
There were no parents there, just the three girls, Nick, Dan and another
friend whom the girls didn't know, Joshua Cole. Their host was Erick Limmer.
They turned on Saturday Night Live. Teen heartthrob James Van Der Beek,
better known as Dawson on the WB show Dawson's Creek, was the guest host.
Melanie took a few sips of a Budweiser and put it down because she didn't
like it. She declined another drink from Josh.
Erick walked into the living room. He threw a baggie of marijuana on the
table and Nick rolled a joint, Melanie said. They watched Jackie Brown, a
crime story about regular people who break the law from time to time.
Melanie poured herself two shots of Apple Pucker liquor mixed with vodka.
The teens were bored, and Josh started to get antsy. Erick left the room to
take a shower.
"Let's play drinking games," Josh said, bringing out a deck of cards.
"No," everyone else replied.
"Do you want something else to drink?" the girls recall Josh asking.
Melanie said she wanted a screwdriver, a mix of vodka and orange juice, and
Samantha said she wanted a Mountain Dew. Josh, Nick and Dan went into the
kitchen. They talked and passed around another joint, Melanie said. Josh
made the girls their drinks.
Josh would later tell police that he wanted the girls to talk more, to act
more lively. He wondered if some of that stuff Erick bought at the strip
club, put into the girls' drinks, would liven up the party.
Dan handed a drink to Melanie, and Nick handed a drink to Samantha, Melanie
said. They were watching Superfly on video, a 1972 movie about a coke dealer
wanting to make one last big score before going clean.
Melanie and Samantha sipped their drinks.
"This tastes gross," Samantha said to her friend. "Can you try it?"
Melanie took a small sip, agreed that it tasted gross and handed it back to
Samantha, who quickly gulped down almost the whole glass of Mountain Dew.
She didn't know it, but she also swallowed GBL, the main ingredient of GHB.
The chemical contains the same ingredients found in floor stripper and drain
cleaner.
Within a few minutes, Samantha passed out on the couch. Melanie sipped the
screwdriver and rapidly felt drunk. She felt her body going numb and tried
to stop it.
Melanie began to vomit. Jessica and at least one of the boys carried her
into the bathroom, where she continued to throw up. After she stopped
vomiting, her friends laid her on her side on a towel in the bathroom "so
she didn't choke," Jessica said.
It was about 2 a.m., and Samantha was still sleeping on the living-room
couch as the rest of the group continued to watch TV. Erick was mad about
the vomit on his carpet and furniture and told the teens to scrub the
cushions and vacuum the carpet.
Then, they heard Samantha gagging and throwing up in her sleep. The other
teens carried her into the bathroom and laid her next to Melanie, two best
friends again sleeping side by side.
If they had taken Samantha to the hospital, she likely would be alive today,
doctors would later say.
Instead, Samantha continued to vomit while she was unconscious.
Vomit went into Samantha's right lung, doctors would later discover. Soon,
the vomit would block air trying to reach her lungs.
The other four teens knew the girls didn't look good, but they didn't think
anything really bad could happen. So they left them there to sleep it off.
While the two girls slept, Nick and Dan drove to Meijer at 3:15 a.m. and
bought carpet cleaner and a $69.99 Hoover vacuum to clean the girls' vomit
from Erick's apartment.
As they put the vacuum together, the teens heard a gagging noise coming from
the bathroom.
Samantha was making "noises and having problems breathing," Jessica
recalled. She checked for a pulse and wasn't sure if she had one. Jessica
and the other boys discussed calling an ambulance.
"No," said Erick, worried about authorities coming to his house. About 4:30
a.m., six teens piled back into Nick's van. Josh carried Samantha, dropping
her on the ice-covered sidewalk as he slipped on his way to the van.
Erick's parting advice: Don't tell anyone you were here.
On the way to the hospital, Jessica saw "white stuff stuck in (Samantha's)
throat" and stuck her fingers in her mouth to try to clear it away.
Melanie, meanwhile, was "breathing funny," Jessica recalled. The girls were
carried into Oakwood Hospital-Seaway Center in Trenton at 4:45 a.m.
Neither girl was breathing.
Neither girl had a heart beat.
"You don't know me, but my name is Josh and I met Melanie tonight and she
got so drunk and passed out and we took her to the hospital."
Those are the words Nancy Sindone remembers waking up to when her telephone
rang about 4:45 a.m. Jan. 17.
A few minutes later, the phone startled another mother, Judi Clark, who had
fallen asleep on the couch. Joshua Cole, a boy she had never met, was on the
line.
He started to give her the same news when the call-waiting beep interrupted
him. It was the emergency room staff.
"Is she there because of alcohol poisoning?" Judi asked the nurse. She knew
there had been a lot of that going on at colleges.
"No," he told her. He didn't tell her it was much worse: The two girls were
unconscious, but they didn't reek of alcohol. Doctors suspected GHB, a
powerful depressant they had learned about at a recent conference.
They had no way to test for GHB, so they treated the girls the same way they
would treat any unconscious patient.
Minutes later, both mothers drove through dense fog to the emergency room.
It was the beginning of a daylong vigil at their daughters' bedsides.
During the first few hours at the hospital, the girls looked identical:
Stark white, eyes shut, tubes stuck up their noses and down their throats.
Hospital gowns replaced jeans.
"They looked dead," Nancy Sindone recalled.
Melanie was breathing slowly and was put on a respirator. Unlike Samantha,
vomit had not reached her lungs. If Melanie had been brought to the hospital
a few minutes later, she likely would have stopped breathing, had a heart
attack and died, doctors said.
Her deterioration was just steps behind Samantha's. Doctors said Samantha
was in such severe shock when she got to the hospital that she was
essentially dead.
"You're wrong," Judi told the doctors. "I have a tough girl there, and she's
going to make it."
Doctors didn't know why Samantha was in a coma. There was no external trauma
and no sign of alcohol ingestion. They mentioned something called GHB, but
said they weren't sure if that was what put her into a coma.
They had no way to know for sure. Oakwood Hospital-Seaway Center, like all
the other hospitals in Michigan, has no way to test for GHB. In some ways, a
test would be irrelevant: There is no antidote for GHB. And because it
generally leaves the body within 12 hours, it may already be undetectable
when a victim gets to the hospital.
Doctors wanted Judi to see her daughter right away. They feared that she
wouldn't live much longer.
Judi tried to go to her daughter's bed, but couldn't. She called her mother
and boyfriend. She couldn't go back there alone, couldn't see her
15-year-old daughter strapped to life support.
Samantha's boyfriend, aunts, and cousins came to the hospital to support
Judi and tell Samantha that they loved her.
About 5 p.m., Judi went home to get clothes so she could spend the night at
the hospital. When she returned, Samantha's bed was tilted and her feet were
sticking up in the air.
The doctor asked Judi to leave the room. Samantha's heart had stopped
beating twice, and it was becoming harder to get it started again. Her
kidneys and liver had already shut down, her blood pressure kept dropping
and her heart overworked itself trying to compensate for the failed organs.
The doctor came out to the waiting room a half hour later. "How many times
do you want to let your daughter die?" he asked Judi.
Judi never answered the question.
Melanie opened her eyes about 17 hours after she closed them on Grosse Ile.
She gagged from the tube that went down her throat and into her lungs to
help her breathe. Her arms were strapped to the bed.
Her eyes were open, but the tube lodged in her throat kept her from asking
where she was and why she was there. Instead, she scribbled short phrases on
scrap paper.
Where am I?
What happened?
Where's Sammy?
Doctors told her that Samantha was in the next room. They mentioned GHB.
Melanie had never heard of it before.
She wanted to see Samantha. Doctors advised against it, but then reluctantly
wheeled her bulky hospital bed to the window of the room next door.
Hours ago, they were lying unconscious on a bathroom floor. Now, Melanie was
looking at Samantha through a window, the closest she could get to her best
friend. She turned to Samantha's mother, Judi, whose face was puffy from a
day of crying. She had to say something. "I'll come clean the house for
you," she told Samantha's mom.
Judi heard what Melanie said, but she didn't know how to respond.
They looked at each other, looked through the window into Samantha's room,
and looked back at each other.
In the silence, tears rolled down their faces.
"I'll clean your house," Melanie said again.
Judi nodded. They both knew that Samantha would never do the household
chores again.
[First Sidebar]
MANY FLIRT WITH GHB, UNMINDFUL OF RISKS
It Attracts Those Who Would Never Touch 'Real Drugs'
A 22-year-old man from Trenton puts five capfuls of GHB into Kool-Aid,
guzzles the drink and passes out within minutes. He has a seizure at home
while waiting for an ambulance.
A 23-year-old man from Grosse Pointe drinks GHB, gamma hydroxybutyrate, from
an Evian bottle at a bar. He begins twitching and has stopped breathing by
the time he gets to a hospital.
A Detroit man, 30, has been using GHB for two months for body building and
euphoria. He bought it from a friend and now can't go more than a few hours
without it. He calls the Poison Control Center in Detroit, wanting to know
about treatment programs for addiction.
A 17-year-old man from Pontiac bought GHB over the Internet. He drinks some
of it, begins vomiting and lapses into a coma. He wakes up in the hospital
four hours later.
This is the world of GHB, a drug gaining popularity in Michigan and
throughout the nation. Although it is best known as a "date-rape" drug, more
than 80 percent of overdose cases are from people who willingly use the
drug. The majority are white men, ages 17 to 30.
Teens and young adults use it to get high without drinking alcohol or
combine the two drugs in a lethal cocktail to intensify a buzz. Body
builders think it will make them stronger.
The recreational users of GHB often buy the chemicals on the Internet and
mix them at home. Unlike illegal drugs that are manufactured in controlled
laboratories, this "kitchen sink" chemistry means there is little regard for
accurate proportions or quality control.
As a result, there are unpredictable - and sometimes deadly - reactions like
those experienced by callers to the Poison Control Center this year. Many of
the calls come from doctors and nurses seeking advice about a possible GHB
victim. The center already has received more than four times the number of
GHB-related calls this year than it did four years ago.
GHB is colorless and odorless with a slightly salty taste. Because it is a
clear liquid, it easily can be masked in other drinks such as water, soda or
juice. There are cases where teens drank "water" from sports bottles, but
really had mixed GHB into the liquid. Their parents or coaches had no idea.
Because only a few drops can get someone high, the drug can be carried in
innocent-looking containers such as Visine eye-drop dispensers.
The drug is attracting people who say they would never touch "real drugs"
such as cocaine and heroin, but want a drug that will relax them like
alcohol.
But because there is a small difference between a dose that will get someone
high and one that will kill, some users find themselves waking up in an
emergency room.
"There is no safe level of use. Nobody can tell you what is a safe level,"
said Trinka Porrata, a drug consultant and former Los Angeles Police
Department detective. "A drop may be too much. A dose that might make a
150-pound woman high can kill a 300-pound man. It's unpredictable."
Dr. Susan Smolinske of the Poison Control Center said more calls lately have
come from people using GHB alternatives, products that act like GHB but
instead contain a related substance that usually is legal. Those products
are sold on the Internet with benign names like Renewtrient, Zen and Blue
Nitro.
The U.S. Drug Enforcement Administration estimates that at least 46 people
have died and 5,500 others have overdosed since 1995. They are investigating
at least 40 more suspected GHB deaths this year.
"It is not some little cult of lost kids who are doing this drug," Porrata
said. "These are the mainstream kids who are using it and dying from it."
[Second Sidebar]
COMMON QUESTIONS ABOUT GHB AND GBL
Q: What are GHB and GBL?
A: GHB and its legal cousin, GBL, were initially sold in health food stores
and used by body builders, who thought the chemicals would stimulate muscle
growth. Both drugs slow down the central nervous system. Once GBL is
ingested, it metabolizes into GHB.
Q: What are the street names for GHB?
A: G, Scoop, Liquid Ecstasy, Georgia Home Boy, Grievous Bodily Harm, Liquid
X, Easy Lay.
Q: What are some products that contain GHB or GBL and are available on the
Internet?
A: Blue Nitro, Revivarant, Renewtrient, Revitalize Plus, Serenity, Enliven,
SomatoPro, Invigorate, Midnight Blue and Zen.
Q: Who is using GHB and GBL?
A: It is usually taken at parties, clubs or raves. It is found at gyms, and
it has been used as a date-rape drug because it is odorless, colorless and
virtually tasteless. It does have a salty taste, however.
Q: What are the effects of GHB and GBL use?
A: It is said to mimic alcohol consumption, producing euphoria in the user.
In larger doses, it can put someone to sleep. In dangerously high doses, it
can induce nausea, vomiting, seizures and coma.
Q: Is GHB legal?
A: In Michigan, GHB is a Schedule I drug, in the same category as heroin or
cocaine. Convictions for making the drug can bring up to seven years in
prison. Possessing the drug can bring a two-year prison sentence. Use can
result in one year in jail.
There is no federal penalty for the drug, but the U.S. House and Senate
recently passed legislation that would put it in the Schedule I category,
making use and manufacture of it illegal except for medical testing. The
bill awaits approval by President Clinton.
The FDA banned over-the-counter sales in 1990.
Sources: The Maryland Drug Early Warning System and
http://www.ashesonthesea.com/ghb
[Third Sidebar]
HOW TO GET INFORMATION
To contribute to the Samantha Reid Fund, write to:
The Samantha Reid Fund
P.O. Box 119
Rockwood, MI 48173
For Information About GHB And Related Substances:
1-800-POISON1
www.ashesonthesea.com/ghb
www.health.org/pubs/qdocs/depress/ghb/frame.htm
www.quackwatch.com/01QuackeryRelatedTopics/ghb.html
www.drugfreeamerica.org/ghb_ne.html
www.fda.gov
www.clubdrugs.org
Overdoses And Sexual Assaults:
If you or a friend has overdosed, call 9-1-1 immediately. If you have been
sexually assaulted, call police or a 24-hour crises enter.
Detroit Rape Counseling Center: (313) 833-1660.
First Step, in western Wayne County: (888) 453-5900.
HAVEN, in Oakland County: (248) 334-1274.
Turning Point, in Macomb County: (810) 463-6990.
[Fourth Sidebar]
IF YOU'RE DRUGGED
Try to save a sample of your drink.
If you need medical care, call an ambulance.
Have a physician test for the drug, which typically leaves the body within
12 hours.
Protect Yourself
Keep an eye on your glass. Don't accept a drink from someone you don't know
or don't trust.
Only accept drinks at a bar or a club from a staff server.
Use the buddy system. Watch the behavior of friends.
Don't drink from a punch bowl or other common source.
Damage drug can do
GHB, taken alone or in combination with other drugs, can depress the central
nervous system.
That has many potential serious side effects, including:
Coma
Seizures
Anxiety
Tremors
Dizziness
Nausea
Vomiting
Confusion
Hallucinations
Respiratory arrest
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