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of so-called "overdose" deaths is the massive pulmonary edema. When
asked the cause of the edema, he cautiously responded:
"This is a very interesting question. To my knowledge it is not known
why the pulmonary edema develops in these cases. . . . This reaction
sometimes occurs with the intravenous injections of mixtures, which as
far as is known, do not contain any heroin, but possibly some other
substance. The reaction does not appear to be specific. It does not
seem to be peculiar to one substance, but it is most commonly seen
with mixtures in which heroin is the smallest component." [29]
In a paper published in the _New York State Journal of Medicine_ for
September 15, 1966, Dr. Helpern again cast doubt on the myth that
these deaths are due to overdose. "Formerly such acute deaths were
attributed to overdose of the heroin contained in the sample injected,"
Dr. Helpern reported - but he went on to cite several lines of
evidence arguing *against* the overdose theory:
". . . Unexpected acute deaths may occur in some addicts who inject
themselves with heroin mixtures even though others who take the same
usual . . . dose from the same sample at the same time may suffer no
dangerous effect. In some fatal acute cases, the rapidity and type of
reaction do not suggest overdose alone but rather an overwhelming
shocklike process due to sensitivity to the injected material. The
toxicologic examination of the tissues in such fatalities, where the
reaction was so rapid that the syringe and needle were still in the
vein of the victim when the body was found, demonstrated only the
presence of alkaloid, not overdosage. In other acute deaths, in which
the circumstances and autopsy findings were positive, the toxicologist
could not even find any evidence of alkaloid in the tissues or body
fluids. Thus, there does not appear to be any quantitative correlation
between the acute fulminating lethal effect and the amount of heroin
taken. . . ." [30]
Dr. Helpern's associate, Deputy Chief Medical Examiner Baden, went on
to further discredit the already implausible overdose theory at a joint
meeting of two American Medical Association drug-dependency committees
held in Palo Alto, California, in February 1969.
"The majority of deaths," Dr. Baden told the AMA physicians, "are due
to an acute reaction to the intravenous injection of the heroin-
quinine-sugar mixture. This type of death is often referred to as an
'overdose,' which is a misnomer. Death is not due to a pharmacological
overdose in the vast majority of cases." [31]
At the same AMA committee meeting and at a meeting of the Medical
Society of the County of New York, Dr. Baden cited six separate lines
of evidence overturning the "heroin overdose" theory.
First, when the packets of heroin found near the bodies of dead addicts
are examined, they do not differ from ordinary packets. "No qualitative
or quantitative differences" are found. [32]  This rules out the
possibility that some incredibly stupid processor may have filled a bag
with pure heroin instead of the usual adulterated mix.
Second, when the syringes used by addicts immediately before dying are
examined, the mixture found in them does not contain more heroin than
usual.
Third, when the urine of addicts allegedly dead of overdose is analyzed,
there is no evidence of overdose.
Fourth, the tissues surrounding the site of the fatal injection show no
signs of high heroin concentration.
Fifth, neophytes unaccustomed to heroin rather than addicts tolerant to
opiates would be expected to be susceptible to death from overdose. But
"almost all of those dying" of alleged overdose, Deputy Chief Medical
Examiner Baden reported, "are long-term users."
Sixth, again according to Dr. Baden, "addicts often 'shoot' in a group,
all using the same heroin supply, and rarely does more than one addict
die at such a time." [33]
These definitive refutations of the heroin overdose theory should, of
course, have led to two prompt steps: a warning to addicts that something
*other* than overdose is causing these hundreds of addict deaths
annually - and an intensive search for the true cause of the deaths. But
neither of these steps has been taken. Hence the news media go right on
talking about "heroin overdose" deaths. "Death from acute reaction to
heroin overdose" and other complicated phrases are also used; these
phrases similarly conceal the fact that these deaths are *not* due to
overdose.
How can the "heroin overdose" myth not only survive but flourish even
after these repeated scientific debunkings? Two stenographic transcripts
provide an answer.
The first is the transcript of a press conference held at the
Rockefeller University on October 27, 1969, in connection with the
Second National Conference on Methadone Treatment. In the course of
his remarks to the assembled reporters, Deputy Chief Medical Examiner
Baden there discussed at some length a case of what he described as
an "addict who died of an overdose of heroin." [34]  The reporters
present naturally referred thereafter to this death as a "heroin
overdose" case.
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