THE BUZZ 2: Usual Suspect

By on May 31, 2017

In Birkholz death, alcohol, drug abuse were largely glossed over.

Artwork Kelly Halpin made in memory of Anthony Birkholz.

JACKSON HOLE, WY – One finding from the recent inquest into the death of Anthony “Tony” Birkholz, who died in January after ingesting alcohol and DMT, was largely overlooked by local media. Birkholz’s death may have had as much or more to do with the amount of alcohol he drank as the DMT he inhaled.

Birkholz’s body was cremated before an autopsy was considered. His death was deemed natural by Idaho’s Bonneville County Coroner’s Office at the time, even though the circumstances leading up to his death were questionable. So aside from blood tests, there is no physical evidence to determine cause of death.

However, Teton County Coroner Dr. Brent Blue told PJH he isn’t convinced a physical examination of his body would have helped because Birkholz “had no other reason to have his airway blocked except for aspiration.” 

What caused Birkholz to die is mostly clear: aspiration and asphyxiation, but what caused that is seemingly unclear. The three-person jury decided he died due to “aspiration secondary to alcohol and 5-methoxy-DMT ingestion.” But Blue was less certain about the relationship between these factors.

Blood work indicated the 31-year-old had THC and alcohol in his system—not cocaine, as local media incorrectly reported, or DMT, which is hard to test for. Witness testimony during the inquest conducted by Blue revealed the local artist took a substance known as 5-Meo-DMT, or the compound 5-Methoxy-Dimethyltryptamine, an offshoot of DMT, the night he died.

Blue wrote the only other major unknowns in addition to the ingestion of DMT brought to light by the inquest were the timing of the events, and the movement of the deceased.

“Mr. Birkholz vomited but it is my belief had he not been turned over and had other manipulations, he would not have aspirated. Therefore, my personal opinion was the only relationship [between his death and DMT] was the vomiting. Obviously, [that is] my pure conjecture,” Blue wrote.

According to Blue, whose first exposure to DMT was during the recent inquest, Birkholz choked on his vomit. Blue posited the man’s death was the result of converging factors and not directly due to the drug DMT or its chemical interaction with the alcohol he consumed that night. Blue wrote, “Often the DMT and 5 DMT do not have synergistic effects. However, DMT causes vomiting more often.”

Birkholz likely choked on his own vomit because of an unprotected airway, a risk associated with excessive alcohol consumption. Birkholz taking DMT could have been the cause for him vomiting—a common occurrence when taking DMT, but also of drinking to excess.

Both DMT and alcohol have potentially similar effects, making cause and effect murky.

In fact, according to Recovery.org, many of the symptoms Birkholz allegedly exhibited—profound disorientation, vomiting, blue or pale skin, slowed respiratory and heart rate, passing out, etc., are all indicators of alcohol poisoning. Alcohol depresses the central nervous system, which controls involuntary actions such as breathing and the gag reflex, making choking a major risk of alcohol poisoning. Hence, the warnings to not let intoxicated friends “sleep it off” and to place them on their sides if you must leave them.

However, DMT also has connections to the central nervous system. It is a naturally occurring tryptamine compound. Tryptamine is also produced in the body and plays a fundamental role in much of its central nervous system regulatory processes.

Not so out of the ordinary

Birkholz’s death may not have been so unusual for a person his age with multiple substances “on board” and a compromised nervous system. And it brings to mind another recent death involving a young person and drugs and alcohol. 

Blue had an earlier conversation with PJH regarding Alexandria “Lexi” Lee Frank, 26, the Jackson woman found dead in her bathtub in April, later discovered to have been under the influence of Xanax and alcohol. The cause of death in that case was technically an accidental drowning. Frank passed out, slipped into the warm water and died, Blue explained.

When asked if Birkholz, too—because of his level of intoxication—could have died in a similar fashion, Blue noted, “If Birkholz had been in a warm bath tub, it is possible he could have drowned as well.” Blue continued, “aspiration implies the inability to protect the airway which can happen in very drunk people.”

But, he said, Birkholz’s blood alcohol content was .18, which for a regular drinker isn’t that high. However, he noted his blood was drawn roughly two hours after his collapse. Blue clarified in a later email, “He had no other reason to have his airway blocked except for aspiration. A BAC of .18 is not high enough for someone to be so comatose that they would not protect their airway.”

According to numerous sources on the elimination rate of alcohol, BAC drops at approximately a rate of .015 percent per hour after a person stops drinking, meaning Birkholz may have had a BAC of approximately .21 when he collapsed.

Then there is the problem with any chemical compound: the risk of the unknown.

While the DMT itself could have been a botched chemistry or cutting job, because the other men who also took the drug were not adversely affected, it is unlikely that was the cause of Birkholz’s death. “Obviously everyone has a different effect of any drug but the fact the other two did not have a problem seems to imply the death was not ‘directly’ caused by DMT,” Blue said.

When asked about the prevalence of overdose deaths in the valley, Blue responded: “We have more alcohol related deaths.”

DMT awakenings?

DMT isn’t Jackson’s drug of choice. Jackson Police Chief Todd Smith said in an email that DMT is not all that prevalent in the valley, but that, “DMT seems to be having a resurgence in the U.S. right now, of which Jackson is not immune.” More common, he said, are alcohol-related poisonings, mainly resulting in hospitalizations and occasionally in death.

According to recovery.org, N, N-Dimethyltryptamine, or DMT, is a drug known for its ability to produce intense visual hallucinations. Risk of DMT addiction is believed to be relatively low, and unlike alcohol, cocaine, or heroin, it does not lead to compulsive drug-seeking behavior.

DMT originated with the usage of ayahuasca, the ancient Amazonian tea derived from the vines of Banisteriopsis caapi and leaves of the plant psychotria viridis; the tea’s hallucinatory effects are due to the DMT compound found in the leaves.

Ayahuasca has been used by shamans in the Amazon to cure illness and tap into the spiritual world and is even consumed by some religious groups in Brazil as a sacrament, explained a March Rolling Stone article. The practice caught on in the developed world too, reaching New York and California, not to mention Jackson Hole, where its users claim it helps cultivate greater self-awareness.

One local woman, who agreed to talk to PJH under the condition of anonymity, used ayahuasca ceremonially in Peru. “It’s like thousands of years of therapy in one night. Ayahuasca saved my life and has done the same for many others. You go way out into the source to find answers,” she said. Though the same woman cautioned against mixing it.

But addictions therapist at Curran-Seeley Ryan Burke is wary about the quick fix mentality he sees. He has doubts about the fast answers people claim to get with drugs like DMT. “You have to put in the work. Take the time to go to a counselor. Put in the effort,” Burke said.

He also warned the valley has a dark side, especially regarding alcohol. He said the things happening in Jackson rival reality television shows like Addiction. He explained there are people who have detoxed at the hospital 50 times and get out of the hospital only to return the same evening to detox again. He noted the U.S. comprises 60 percent of the world’s illegal drug market with only six percent of the world’s population.

“Everyone wants to be happy all the time and put on a happy face. Natural cycles have down time and people try and avoid it,” he said.

In response to a question regarding Birkholz’s personal accountability, Blue wrote, “There is no question that Mr. Birkholz did something irresponsible. It was the juror’s opinion that had he had the proper intervention at the proper time, he would have lived.”

When asked about personal responsibility and accidental deaths involving drugs and alcohol Burke said, “You never want to speak ill of the dead, but if you don’t speak up it’ll continue to happen.” PJH

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