The Chauvin Defense? New Research Shows Alarming Increase In Fentanyl Abuse and Deaths

As the trial of former police officer Derek Chauvin starts in Minneapolis, much of the trial will focus on the role of fentanyl in the body of George Floyd as the possible cause for his death. Notably, a new study in the last week reinforces prior research showing an alarming increase in the abuse of this powerful drug and deaths associated from it.  In some counties, there was an almost 75% increase in the first half of 2020 in fatal drug overdoses with fentanyl as the main culprit.

While Floyd denied using drugs, he later said he was “hooping,” or taking drugs. That was confirmed in the autopsy which found that Floyd died from “cardiopulmonary arrest while being restrained by law enforcement officer(s).” The state’s criminal complaint against Chauvin said the autopsy “revealed no physical findings that support a diagnosis of traumatic asphyxia or strangulation. Mr. Floyd had underlying health conditions including coronary artery disease and hypertensive heart disease.” He also was COVID-19 positive.

Andrew Baker, Hennepin County’s chief medical examiner, strongly suggested that the primary cause was a huge amount of fentanyl in Floyd’s system: “Fentanyl at 11 ng/ml — this is higher than (a) chronic pain patient. If he were found dead at home alone & no other apparent causes, this could be acceptable to call an OD (overdose). Deaths have been certified w/levels of 3.” Baker also told investigators that the autopsy revealed no physical evidence suggesting Floyd died of asphyxiation. The toxicology report on Floyd’s blood also noted that “in fatalities from fentanyl, blood concentrations are variable and have been reported as low as 3 ng/ml.” Floyd had almost four times the level of fentanyl considered potentially lethal.

That level of fentanyl will be tied to Floyd complaining about being unable to breathe. Floyd stated that he could not breathe while sitting in the police cruiser and before he was ever restrained on the ground. That is consistent with the level of fentanyl in his system that can cause “slowed or stopped breathing.”

Notably, the report shows that Floyd had both fentanyl and methamphetamine in his system. That is the combination discussed in the recent study (and past studies) as a commonly lethal combination.

The new Quest study shows that lethal overdoses overwhelmingly involve combinations with fentanyl, particularly methamphetamine: “Most overdose deaths involving opioids such as fentanyl also involve concurrent use of benzodiazepines, cocaine, or methamphetamine.”

The expert testimony on such combinations will be the key to the trial of Chauvin. Much turns on the result. Indeed, there is a real danger of a cascading failure of all four cases if the jury hangs or acquits.

As I have previously noted, the role of fentanyl does not mean that Chauvin has an insurmountable defense. It makes this a stronger manslaughter than murder case. However, Floyd was clearly in distress and one of the other officers suggested moving him (which Chauvin countermanded). That could still constitute manslaughter if Chauvin knew or should have known that his knee restraint was endangering Floyd’s life.

109 thoughts on “The Chauvin Defense? New Research Shows Alarming Increase In Fentanyl Abuse and Deaths”

  1. While Floyd denied using drugs, he later said he was “hooping,” or taking drugs.

    “Hooping” means taking drugs anally.

  2. Good riddance to George Floyd. I wonder how many people he killed? Because drug users are also dealers/swappers/traders a lot of the time. I GUESS George probably gave Fentanyl to others and I wonder how many of them said, “I can’t breathe!” as they died?

    Squeeky Fromm
    Girl Reporter

  3. People shouldn’t underestimate the impact of this witness — Alisha Oyler.

    She produced the video recordings that are being introduced. And there’s also this:

    https://kstp.com/news/opening-statements-get-underway-in-derek-chauvin-trial-george-floyd-death/6056554/

    ‘Oyler was asked why she kept recording the incident as it unfolded.

    ‘”Because I always see the police and they’re always messing with people and it’s wrong,” she replied.’

    1. Her video only tells part of the story.
      The physical evidence and other testimony say a bit more.

      With what is considered a lethal dose of fentynal on top of Floyd’s medical history, the prosecution has a very high bar to exceed.

      Based on testimony, Floyd was placed in the back of a squad car when he started to complain about not being able to breathe and started to become non-compliant. (resisting arrest) Its at this point Floyd was starting to die. This was before Chauvin’s car was present and before the girl’s video started.

      I’m not going to play doctor, but as Turley has pointed out … the loss of breath that Floyd was complaining about is the start of the cardiac arrest.

      1. “I’m not going to play doctor,…”

        Good. Don’t.

        https://www.washingtonpost.com/health/george-floyd-fentanyl/2021/03/10/c3d4f328-76ec-11eb-9537-496158cc5fd9_story.html

        “The video of Floyd gasping for breath and dying beneath Chauvin’s knee that evening ignited a social justice movement and nationwide demand for policing reform. But when Chauvin’s trial for his alleged role in Floyd’s death begins, much of the argument will center instead on the autopsy details, most specifically whether fentanyl and underlying health conditions — not the police officer’s actions — stopped Floyd’s heart and lungs.

        “Seven experts in toxicology, cardiology and illegal drug use consulted by The Washington Post largely disagreed with that idea, most of them strenuously. All but one said the autopsy findings and other court documents, coupled with the well-known chain of events that evening, made death by a fentanyl overdose unlikely to impossible. (One expert, Craig Beavers, chair of the American College of Cardiology’s cardiovascular team section, said he did not have enough information about all the circumstances to form a final conclusion.)”

        — Washington Post

  4. Some interesting arguments by Chauvin’s lawyer in a “court filing” this pass September:

    https://www.nytimes.com/2020/09/11/us/derek-chauvin-george-floyd-trial.html

    Excerpt:

    Mr. Lane and Mr. Kueng, two inexperienced officers who were the first to arrive on the scene of a complaint that Mr. Floyd had used fake money, failed to properly assess and de-escalate the situation, Mr. Chauvin’s lawyer argued in a court filing this week, noting that Mr. Chauvin arrived to the scene later.

    “If EMS had arrived just three minutes sooner, Mr. Floyd may have survived,” the lawyer, Mr. Nelson, wrote. “If Kueng and Lane had chosen to de-escalate instead of struggle, Mr. Floyd may have survived. If Kueng and Lane had recognized the apparent signs of an opioid overdose and rendered aid, such as administering naloxone, Mr. Floyd may have survived.”

    — New York Times

    1. It’s the police department, not the local pastor and a basket full of charity.

      It’s what criminals attract…the long arm of the law.

      If you can’t do the time, don’t do the crime.

    2. “. . . Mr. Floyd may have survived . . .”

      If Mr. Floyd had not chosen to take drugs, he may have survived.

      If Mr. Floyd had not chosen to pass counterfeit money, he may have survived.

      If Mr. Floyd had not chosen to resist arrest, he may have survived.

      If Mr. Floyd had not chosen a life of crime, he may have survived.

      Gotta love criminal-huggers. Criminals are never to blame; police always are.

    1. Anything is possible, but who knows and what meaning does it have. The important thing is we don’t know what Chauvin was willing to settle for if that is true. Remember, once again we are dealing with anonymous figures that have been lying almost continuously for over 4 years.

      “The officials spoke to The Associated Press on condition of anonymity “

      This has been the typical Story from Anonymous the Stupid since the Steele Dossier, the Russia Hoax, The Ukraine Hoax etc. If the Muppets say something Anonymous the Stupid likes he will quote them.

  5. If Floyd was having breathing issues before he was kneeled on, then that makes it just worse because the cop was then on notice that there was a medical issue and should have been more careful.

    1. He physically fought with the police to avoid arrest and the cops were sympathetic to his claims of not being able to breathe, which he claimed being claustrophobic while resisting being put in the cop car..
      I for one know the feeling of not being able to breathe when being arrested. I also know the feeling of being ‘dealt with’ for resisting arrest. The difference is, i didn’t stand a chance, unlike Floyd, who seemed to be nearly successful on several attempts to resist his arrest..

    2. Turley concludes that manslaughter is a more likely result. But doesn’t that also require proof beyond a reasonable doubt that the restraint caused the death? It is too bad the prosecution did not find a charge that would avoid having to prove cause of death beyond a reasonable doubt.

      1. Daniel: “It is too bad the prosecution did not find a charge that would avoid having to prove cause of death beyond a reasonable doubt.”
        ***
        Manslaughter does require proof beyond a reasonable doubt but the state has found a method that does not require that standard: Mob Justice.

    3. ‘They should have been more careful”. Molly have you watched all the police cam videos? Floyd was out of control. Are there things that police could have done differently? Yes. But when you broke the law and resist arrest, bad things happen.

    4. Why was Brotha Floyd kneeled on?

      If Brotha Floyd had wanted care, he should have gone to the doctor, not to a life of sloth, drug abuse and crime.

      The American thesis is: Freedom and Self-Reliance.

      If America and its police were so bad, why didn’t Brotha Floyd go back to Africa to “…Don’t Worry, Be Happy?”

      If you play with fire, you’re gonna get burned.

  6. Should have a lot more of these overdoses and deaths since our borders are now wide open. But hey, don’t we all feel good that Biden is such a “nice guy?”

  7. I am surprised at Professor Turley’s blatant victim-blaming here. What killed George Floyd was inhumanity and criminal stupidity. The fentanyl defense must be refuted. Fentanyl? Artery disease? Mr. Floyd complaining of breathlessness while in the squad car? Yet officer Chauvin compressed Mr.Floyd’s neck with his knee for nine minutes.

    1. “Mr. Floyd complaining of breathlessness while in the squad car? .”

      One gets that with a Fentanyl overdose. Drug overdoses cause acute respiratory distress syndrome characterized by shortness of breath.

      If “while in the squad car” Floyd was “complaining of breathlessness “ that is likely from the drugs.

        1. Anonymous the Stupid, I understand time zones. You don’t understand restraint and will post day and night almost 24/7 insulting people at the same time you make Stupid remarks.

          My statements about Fentanyl can be verified on almost any legitimate site. That you didn’t know it to be true further documents your Stupidity.

          1. “your nighttime posting of 1:58AM shows you to be an insomniac” -S. Meyer

            Nothing that this guy says should be trusted; he reaches faulty conclusions all the time.

            He’s the old ‘Allan,’ too. Hover over that gravatar of his.

            His favorite word is “stupid.” Hmm… Gotta wonder.

            1. Anonymous the Stupid, You are obsessed with Allan. With all the hints I have left lying around only the Stupid have to spend much time figuring things out. You are the Stupid.

              1. Nope. It’s the other way around — quite obviously — with all this “Anonymous the Stupid” BS.

                1. Anonymous the Stupid, anyone hearing you talk about Allan knows he is in your head and you can’t get him out.

                  Try watching reruns of Cuomo receiving his Emmy. Applaud while doing so. Maybe you can displace one vision with another.

            1. I think I answered your later Stupidity, Anonymous the Stupid so this makes #4.

              I hope everyone is throwing out anonymous replies so they don’t have to go through so much trash.

              1. Another brilliant deduction (not!) on this AH’s part.

                Some people actually come to the blog itself and read the comments.

                What a silly game and non-productive game that he’s playing.

                1. Anonymous the Stupid, you like to hide. I am making it more difficult for you to hide and in the process exposing your extreme lack of any intellectual thought.

                  Why don’t you tell us about your love affair of Cuomo and how when he won his Emmy you felt you were at the height of your glory.

      1. A toxicologist, also named “Nelson” (but not to be confused with Chauvin’s attorney) comments:

        https://www.washingtonpost.com/health/george-floyd-fentanyl/2021/03/10/c3d4f328-76ec-11eb-9537-496158cc5fd9_story.html

        ‘Nelson, the toxicologist, said “it is not inconceivable” that fentanyl caused some respiratory depression in Floyd, but the drug’s impact cannot be considered separately from the officers’ behavior. Had Floyd been alone, he “probably wouldn’t have died,” Nelson said.’

        1. Anonymous the Stupid, how many CIA agents and at another time DOJ lawyers etc. signed onto garbage. It is easy to get people to say what you want them to say.

          Go back to the muppets or better yet call up Cuomo and see if you can’t get a picture with him holding up his Emmy while you applaud.

      2. Yes. We know that overdose can lead to shortness of breath, so can coronary artery disease. The two together are devastating. Now factor in a cop who believed he was acting within procedure by choking the suspect, who apparently did not hear George Floyd as he sat in the police car saying he couldn’t breathe.

        Like I said: Inhumanity and criminal stupidity.

        1. Voice: “Now factor in a cop who believed he was acting within procedure by choking the suspect”
          ***
          Chauvin was acting within procedure published by his police department together with a picture demonstrating the technique.

          And he was not ‘choking the suspect’, but I suppose you know that. You would openly know that if the cop were black and the suspect white.

          If the procedure was faulty the blame lies with administration, including the black chief of police and the ‘oh so woke’ Democrat city government.

        2. “by choking the suspect,”

          There is no evidence of that and likely he maintained very little pressure.

          Voice, I had the same feelings as you when I initially saw the video but then I looked at the facts. Homicide is crazy and so is manslaughter. The question in my mind is what was in the mind of Chauvin at the time and whether his procedure was justifiable according to the laws he was working under. We have seen police officers killed when they release the criminal to early. If Floyd was in a combatitive state, Floyd might have been physically injured by the cops trying to restrain him and there could have been injuries to the crowd or other police officers. There was a crowd and maybe Chauvin felt it was best to keep his hands free.

          I may not like what Chauvin did or the results, but mob justice is not the way to go. We have to have a solid criminal foundation and that I do not believe exists unless a good argument can be made for the last 3 minutes of the tape.

          There is little question in my mind that the cause of death was Fentanyl. Nelson more or less said that in a comment later even though news articles tried to show a different statement by inserting a few words into an opinion piece spinning what he actually said.

          1. “There is no evidence of that [choking]”

            ***
            No, there isn’t, but there IS evidence of No Choking in the autopsy report.

  8. Same facts with black officer and white arrestee there would be no publicity, no riots and no trial.

    Professor Turley’s analysis is succinct, precise, and so accurate it is a pleasure to read.

    1. I couldn’t agree more with you my friend. Not only on this article but all other articles I thoroughly enjoy reading Jonathan Turley. I guess I’m about as conservative as they come in yet I not only thoroughly enjoy reading just about everything he comes out with, I enjoy listening to him every time tucker Carlson or Sean Hannity, Laura Ingraham, or Judge Jeanine has him on.

      Btw, mini folks don’t know what I’m about to type next. And that is, Judge Jeanine is an old school Liberal. And yet, millions and millions of Conservatives think, she is a dyed in the wool Conservative. It goes to show once again and again, just how much old school liberals held Conservative beliefs. What nearly all of the old folks simply called having,
      “Common sense beliefs.”

  9. Drugs or knee on neck did it…..Example:

    Drugs did it! Michael Jackson died from a massive overdose of propofol and benzodiazepine intoxication.

    Michael Jackson’s doctor, Conrad Murray was found guilty of involuntary manslaughter.

    1. The reason he was found guilty is because of “over-prescribing” the drugs that killed him, and for administering the drug at home. Instead of in a hospital setting. Which I never agreed what does part of the charge. He administered the injection himself into Michael Jackson. The man was, a doctor at the time.

      Granted, before the death of Michael Jackson this drug, “Propofol”, had always been administered in a hospital and the patient had always been placed under, “medically close-watch.” And this means after each time a patient was injected with this drug the nurses on duty had to visually check up-on the patient no more then 15 minutes on a rotational basis, and sign the “visual-rotational-ledger”. Called the, VRL.

      I thought I would share with you a little bit of background historical reference that might shed some light on this doctor situation back then pertaining to his life. He was without a doubt drowning in debt. And for being a doctor he definitely did not practice common sense. Let’s turn now to what I located very quickly.

      “At the time that he began working for Jackson in May 2009, ] Murray had reportedly fathered seven children by six different women.

      (This phenomena is unbelievably out of control among black males. In fact, it is completely out of control among black, professional basketball players. More than any other professional sport with black males. Although, black professional football players give them a run for the money. The garden variety black basketball player by the time he retires has fathered five children by five different women. I am, not kidding you. None whatsoever. In fact, I went and grabbed this for you.)

      “ In 1998, Sports Illustrated published a cover story called “Where’s Daddy?”: “Although there have been no studies on athletes and their out-of-wedlock kids, those who are familiar with the issue say the numbers are staggering. ‘I’d say that there might be more kids out of wedlock than there are players in the NBA,’ estimates one of the league’s top agents, who says he spends more time dealing with paternity claims than he does negotiating contracts.” If you want to see article after article, link after link after link pop up like a piece of toast, then put these words in any search engine.

      “ Black professional basketball players that have fathered out of wedlock children.”

      (Back to what I went and got for you pertaining to the Doctor.)

      “He was in arrears on the mortgage for the Las Vegas home occupied by his first wife and children and owed child support to the mothers of children outside of his marriage, which he could not pay due to the amount of money he owed to Michael Jackson’s family. He was married to Blanche, his second wife, whom he met at medical school, and helped pay rent for another woman, Nicole Alvarez. Murray met Alvarez at a gentlemen’s club in Las Vegas when she worked as a stripper, and Alvarez gave birth to their son Che Giovanni Murray in March 2009. Another relationship, with a cocktail waitress from Houston, was also reported.”

      “Murray was at risk of losing his California medical license due to unpaid child support to one of his children and owed $13,000 to a California woman, Nenita Malibiran. Murray was a defendant in numerous civil lawsuits (though none for medical malpractice). By 2008, he had accumulated over $600,000 in court judgments against him for medical equipment and unpaid rent for his practices in Texas and Nevada. He also owed $71,000 for student loans at Meharry Medical College. Murray filed for bankruptcy in 2002, in California. Murray expected to go back to jail in September.”

  10. So if the cause of death is NOT asphyxia or strangulation, why is this case not subject to a very well taken motion for a judgment of acquittal? Or is the state going to jettison its own ME and rely on the testimony of Dr. Baden, who is making money off of the Floyd settlement? There is a built in reasonable doubt. No way this guy gets convicted and if he does, the judge should have the courage to overturn it. Does anyone seriously believe if there had been no attendant publicity, this case would even have been brought?

  11. Druggies need guns. Guns are quicker than the drugs. Shoot yourself in the head brother Floyd. Like your bro should have.

    (Music )
    Suicide is dangerous.
    Does that mean anything to you? Then legalize marijuana. Hoo hoo hoo.
    Right here in sweet Jamaica. Hoo hoo hoo.

  12. It doesn’t matter anymore what the cause of death was. The mob outside the courthouse and the influence it has on the jurors, will be the elephant in the room. We no longer have rule of law in the U.S., it has become like the wild west of old. “Give ’em a fair trial, and then hang ’em.” The mobs, supported by the media and the racist warriors, will rule the day and facts or not, Mr. Chauvin (whom we have all seen on tv and have a hate for), has already been convicted and will be again by the jury.

    Having a trial in this case, is pro forma at best.

  13. Logical arguments or evidence will not satisfy the mob, which has been allowed to confiscate a section of that neighborhood and control the street, much to the despair of the businesses in the neighborhood. I’m afraid the vigilante mob in Minneapolis is out for revenge, not “justice.” RIP Minneapolis.

  14. To my mind Chauvin absolutely did wrong in his treatment of Floyd.

    No policeman should behave that way.

    And he should be punished.

    But was he guilty of murder?

    Minneapolis just gave the family a $27MM settlement – just before the trial.

    That ensures the jury will know that the city believes that they are responsible.

    Political virtue signaling that denies Chauvin a fair trial.

    That is not justice.

    1. No it isn’t. The city settled with the family and they made damn sure that the media knew about it before this trial. And it’s quite obvious they couldn’t wait to settle with them. By giving this degenerate family $27 million they made sure that they bought themselves the verdict they long to see be given at the end of this trial.

      This is without a doubt the most costly is set up in history!! it’s beyond disgusting what is being done to this police officer. His only hope from what I can see, is on appeal. And on appeal he most definitely would win.

        1. since I have a medical background all prescription drugs for pain are ADDICTIVE…so is alcohol and nicotine…your body just keeps wanting more and more until you are dead from an overdose…George Floyd died from an overdose with the additional fear of being taken to jail for forgery…any other person would have never resisted arrest…sort it out at the police station…the family has been paid off…my worry is BLM riots if there is no conviction.

    2. “No policeman should behave that way.”

      There is a perception that Chauvin wasn’t caring. Whether or not that perception is true, that is not a criminal act.

      Chauvin followed the training manual which taught knee on neck, but the optics aren’t good. Is that a criminal act?

      There was no physical damage from Chauvin’s knee so does the knee not doing physical damage make it a criminal act?

      The knee was left longer than one would like but is that a criminal act?

      What would make the actions criminal is if substantial evidence is produced that he went outside of normal procedures or that he acted against normal procedures for the police department he was a member of. The most important thing is what his motives were but we don’t have anyway of knowing them without him telling us.

      1. Didn’t Hannity tell you what the 911 dispatcher said–she called the police on the police, and even said she didn’t care if they branded her as a snitch because she knew that what she was watching was wrong. Floyd had physical damage: road rash on his chest. What, exactly, was Chauvin taught as justifiable grounds for kneeling on someone’s neck, especially someone who is not resisting and who is handcuffed?

        1. Maybe we’ll hear from Chauvin’s ex-wife, at some point; perhaps down the road, she’ll agree to an interview.

          She likely won’t be testifying, but one has to wonder what went on in their marriage, etc. As we know, she certainly didn’t stick around to support her then husband.

        2. What does Hannity have to do with anything?

          Check out the manual that teaches policemen how to restrain a person resisting arrest.

          SM

    3. Will you say the same if a junkie breaks into your home and rapes, destructs, steals and murders? Seriously.

    1. if you watch the video carefully the knee rises when he was breathing and this method of restraint is taught to every officer in MN…again case should have never gone to trial. I had my wife put her knee on the side of my neck…I could breathe just fine and she was pressing very hard.

    1. I wouldn’t say “a fatal overdose level is 3” (ng/mL). In fact, 3 ng/mL in vivo is at the upper end of the normal therapeutic dose for analgesia. What he’s saying is that medical examiners have ruled a death an overdose on the basis of such levels, where no other plausible cause of death presents itself. It’s a diagnosis of exclusion. In practice, there have also been plenty of autopsies ruled death by other causes, natural causes, with fentanyl levels higher than George Floyd had. Floyd’s fentanyl levels were actually on the lower end of what are typically seen in overdose deaths. This is what the medical examiner was talking about when he described post-mortem fentanyl levels as “highly variable”. Could 11 ng/mL have caused Floyd’s death? It’s plausible. Is 11 ng/mL non-survivable? That’s far from established.

      1. DaveL: there is no need for Chauvin to prove the drug caused the death. All he needs to show is that the presence of the drug raises a reasonable doubt that the restraint caused the death. Moreover, he only needs to persuade one juror that there is reasonable doubt. If the jurors look at this objectively, and if the ME is not discredited on the stand or through the testimony of other experts, it is hard to imagine that not one juror would find reasonable doubt. So, if Chauvin is convicted in this circumstance, it would likely be because none of the jurors responded objectively to the facts before them.

        1. Chauvin’s lawyer is trying to confuse the jury to divert their attention away from Chauvin’s conduct by asking them to guess that fentanyl overdose was the true cause.

          IF DOCTORS CANNOT AGREE THAT FENTANYL PLAYED A ROLE IN FLOYD’S DEATH, THEN HOW CAN JURORS, WHO ARE NOT DOCTORS? Jurors should not ever have even heard argument on this, because it is prejudicial and speculative. It’s intended to mislead them, just like the opening argument of Chauvin’s lawyer about “reasonableness”. There’s nothing “reasonable” about this at all. Floyd’s cause of death was cardiac arrest while under restraint. Other findings were listed as they are in all autopsies, but fentanyl was not listed as the cause of death. His post-mortem levels are not predictive of pre-death levels, and even Turley’s ME comment is tempered with the qualifier: “in the absence of other apparent causes.” Floyd had road rash on his chest due to being ground into the pavement for 9 1/2 minutes. Chauvin wouldn’t check for a pulse, and wouldn’t release Floyd even after he stopped moving and even after he stopped breathing. Chauvin is a killer. The degree of culpability is a proper question for the jury, but Chauvin’s conduct is indefensible.

    2. From the National Institutes of Health, Annals of Toxicology

      Fentanyl: toxic or therapeutic? Postmortem and antemortem blood concentrations after transdermal fentanyl application
      Hilke Andresen 1 , Annemarie Gullans, Michele Veselinovic, Sven Anders, Achim Schmoldt, Stefanie Iwersen-Bergmann, Alexander Mueller
      Affiliations

      PMID: 22417834 DOI: 10.1093/jat/bks005

      Abstract

      In forensic toxicology, several fatal intoxications with fentanyl have occurred in the recent past, but there are rare discussions in the literature of postmortem fentanyl blood concentrations subsequent to lethal and non lethal applications. To study this problem, we analyzed postmortem blood concentrations (vena femoralis) of 118 cases with therapeutic use of fentanyl and compared them with serum levels of 27 living persons after therapeutic administration of fentanyl patches (Durogesic). Basically, blood concentrations in postmortem specimens cannot be directly compared with in vivo serum levels: in our study, we observed that postmortem fentanyl blood concentrations were on average up to nine times higher than in vivo serum levels at the same dose. These differences could be explained by postmortem redistribution, but they were higher than expected on the basis of the physical and chemical properties of fentanyl alone. The special pharmacokinetics of the drug after long term transdermal application seem to play an important role in this phenomenon. In addition, there was no clear correlation between transdermal fentanyl dose and blood or serum concentrations, either antemortem or postmortem. Our study provides extensive data for postmortem peripheral blood concentrations after therapeutic non-fatal fentanyl patch application and demonstrates once more that in forensic toxicology, blood concentrations must be holistically interpreted with respect to all aspects of a case.

      It is not possible to state what Floyd’s pre-death fentanyl levels were because there is no correlation between post-mortem and pre-death levels. Case closed.

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