Billy Mays, 1958-2009.
You may have read recently that legendary pitchman, Billy Mays, died from heart disease. You may have read further that an autopsy revealed that cocaine was found in his system. Was cocaine the cause of Billy Mays’ death?
Not likely, because Billy Mays died from heart failure – although, cocaine may have been a contributing mechanism for that death.
How would a medical examiner know to look for drugs, and how does cocaine show up in that autopsy – especially when the medical examiner may not be looking for that specific chemical in the body?
While most drugs don’t cause visible changes in the body, they leave behind their mischief in the body’s cells – where most medical examiners cannot go. Therefore, the medical examiner collects fluids and tissues from the body during an autopsy and sends them to a toxicologist. The toxicologist, then, analyzes the fluids and tissues for the presence or absence of toxins. Even when the toxicologist cannot find a toxin, he or she may be able to view its affects through transformation, or the conversion or transformation of one chemical into another in the body.
Cocaine is one of the most widely used amphetamines, also called “uppers” or stimulants. Cocaine users often develop tachyphylaxis, which means the body gets used to the cocaine and the effects are lessened with each use. As a result, users must take ever-increasing amounts to get the same kick they found the first time they used the drug. Cocaine is in such wide use that testing for this drug is virtually every part of a hospital’s or crime lab toxicologist’s test screens.
In the bloodstream, cocaine is converted to methylecgonine and benzoylecgonline. Urine tests target the latter of these two compounds and can find traces for up to three days after the last use (In 2005, scientists found surprisingly large quantities of benzoylecgonine in Italy’s Po River and used its concentration to estimate the number of cocaine users in the region). Toxicologists may use both immunoassay and the Scott Test (not always reliable) as screening tests of cocaine. Mass spectrometry, however, can give the most accurate assessment of cocaine use in a human body.
Although Mays had no history of drug abuse (he had prescription painkillers for a hip problem), Hillsborough County Associate Medical Examiner Dr. Leszek Chrostowski, still performed toxicology tests per standard procedure. As a result, he stated in a press release that “Cocaine use caused or contributed to the development of his heart disease, and thereby contributed to his death.”
If someone with significant coronary artery disease (CAD) takes cocaine, that person’s heart rate increases and his clogged arteries cannot accommodate the demand. The cause of death would be a heart attack, but the cocaine would be a contributing factor. Billy Mays also had a family history of heart disease; but, in light of this new information about cocaine, Mays’ family plans to contest the autopsy report.
Today’s top killer diseases in the United States include heart disease, cancer and stroke. Men and women both are susceptible to these diseases, which cover such ailments as coronary artery disease, heart failure, heart rhythm disorders, all types of cancer and ischemic and hemorrhagic strokes. These diseases, once developed, often are fatal.