Trigger Warning: meandering discussion of suicide and substance abuse
This RS article rocked me to my core, kept me up writing and thinking two nights in a row.
Depression, trauma, substances. Stigma, shame, and suicide.
First, the substances. Ativan is usually prescribed in 1 mg tablets. No matter how it is administered, 4 mg is the max recommended dose. The nanograms per milliliter of blood measurement used here is extremely difficult to translate, even using an online conversion tool, so I have no idea how much he actually had ingested, but I am guessing 5-6 mg since they are saying more than the usual dose but not one normally associated with fatality. That makes sense according to his wife’s statement that he took “a couple extra.”
Info about Ativan (lorazepam): https://www.drugs.com/amp/ativan.html
Butalbital as far as I know is not available by itself but is commonly prescribed in a compound formula for “tension” headaches which most specialists now understand are part of migraine disease. The brand name of the butalbital/ caffeine/ acetaminophen compound is Fioricet. I have used this med on and off my whole life, formerly concurrent with Xanax or Ativan. It also is available with codeine, which is what I had been prescribed (I now have Fioricet without codeine and no longer take anti-anxiety meds). The article does not mention acetaminophen, but does mention caffeine, which they claim was from No-Doz.
Info about Butalbital, a barbiturate: https://en.m.wikipedia.org/wiki/Butalbital
Did Chris suffer from migraines? Or as a rock star in recovery, was he able to get this combination of meds specially prescribed for anxiety and / or insomnia? Many former drug users in recovery are prescribed Ativan. (But why take caffeine separately, particularly with sedatives? Was it a “cocktail” he’d discovered that produced a non-narcotic, non-alcoholic high?) The naloxone is interesting too. It’s an antagonist, but in combination with these other drugs it could (maybe?) act similarly to a narcotic in increasing the effects of the depressants. Naloxone only stops the action of opiates. [Editing again to add that I read one article stating Naloxone (Narcan) may have been injected by emergency responders after he was found.]
Also in his system when he died was pseudoephedrine, brand name Sudafed. It is taken for sinus pain / headache which also can be part of migraine disease. Like caffeine, it is a stimulant. The combination of sedatives, barbiturates, and stimulants is particularly dangerous.
In my 20s and 30s there were many instances when I took the above meds together as prescribed for migraine, with an opiate as well, and then combined them with a lot of alcohol during nights of social binge-drinking. I also had occasional extreme mood swings which, I realized with prompting from John, after I was no longer taking it, were brought on by the Fioricet 3 (w/ codeine) in particular, exacerbated by the anti-anxiety meds. These sudden bursts of intense emotion included both violent rages and severe depression. [Editing to make clear that the violence was against inanimate objects, not people or myself.]
As well as feeling incredibly sad about the circumstances surrounding Chris’s suicide, I am sort of feeling damn lucky to be alive. I think I am made of stronger stuff than I realized.
I keep adding to and revising this post. And I am so fucking sad, getting more and more so. Chris Cornell was a grunge success story, a man who grieved for and celebrated the tragic deaths of friends and fellow musicians, most famously in Temple Of The Dog, and who seemed to triumph over trauma to choose life, to choose music and family and love and philanthropy and friendship over giving in to despair. John told me the song “Slaves & Bulldozers” basically saved him as an adolescent recovering from abuse. He sent me the lyrics in a text the day Chris died, and they read as though Chris himself may have been molested or raped. As fans know, he ended with that song in Detroit hours before his death, blending it with “In My Time of Dying” by Led Zeppelin. If my wings should fail me Lord, please meet me with another pair. / I hope I did somebody some good. / So I can die easy….. The song is filled with Catholic imagery. Like John, Chris went to Catholic school. Like John, he seemed to worry about his soul. Like John, his parents got divorced, and considering Chris chose to use his mother’s maiden name in the aftermath, it may have been messy and horrible.
I just read an article about how the stories surrounding this death relate to the stigma involved with suicide as well as medications. When someone dies from opening up the veins in their arms, the razor blade isn’t blamed, the author said. I see her point, but also see the flaws in that argument since weapons don’t alter one’s thoughts the way many drugs can. I maintain my agreement with Vicky and my own statements throughout this post regarding the devastating mood effects the combination of butalbital, caffeine, and Ativan can have. HOWEVER. Depression leads to suicide. Ativan and Butalbital did not kill Chris Cornell. Depression did. The meds may have altered that triumphant will to live despite the darkness just enough for him to give in to the rain that couldn’t, finally, be washed away. Depression needs to be discussed without shame and blame. Depression kills.
As for me, please know that I am MUCH more careful with medications now. There is no reason to worry about Current Me. But Past Me? Damn girl, that was some stupid, careless shit. Careless because of my occasional choice to start drinking before all the chemicals were out of my system; but yet, I was taking legitimately prescribed meds for the symptoms of my illness. And I could have died. Why didn’t I? Other than occasionally wanting to go to sleep and never wake up I have never truly felt suicidal (exceptions would be when I took Topamax and other anti-epileptics, but even then it was sleep forever type suicidal). I have never had to engage in that fight to overcome constant thoughts of ending my life.
I am more relieved than I can say that my family was spared the agony Vicky and her kids are enduring right now, because I think she was right. Without that strange but familiar-to-me cocktail of meds, maybe Chris would not have taken his life after surviving so much for so long; after publicly grieving the early deaths of his friends and contemporaries; after marrying again and producing children who are still young (he also has as an older daughter). There but for the grace of John, X, & Zo go I, as paraphrased from Winston Churchill, Sherlock Holmes, and Simon & Garfunkel. Or maybe, I simply was never at that kind of risk because my own depression never convinced me my family would be better off without me. Suicide is not selfish. For those who suffer that severely it can feel like the only option. Suicidal ideation, especially exacerbated by mind-altering drugs, tricks you into believing your loved ones will be better off without you to bring them down and perhaps ruin their lives as your own feels ruined beyond redemption and repair.
Chris Cornell, you beautiful, troubled man, thank you for creating art that soothed my traumatized partner in his youth. Thank you for your words and your voice, which sustained much of Generation X when we were falling on our own black days. What trauma did you suffer in your own childhood that created the anxiety and depression you sang about and spoke of in interviews? What supreme sadness bubbled to the surface that made death seem like the only way out?
This post has morphed many times. It no longer flows as well as I’d like. But there is nothing easy about discussing depression, trauma, grief, and suicide. PLEASE, readers of my blog, sufferers of chronic pain and depression and PTSD, substance-users, whether illicit or prescribed or both, trauma survivors, suicidal-thought fighters, you are not alone. You are worthy. Whether I know you or not I am glad to share this planet with you. Get through the next hour, the next day, one moment at a time. Get help.
I am so glad I got to see Chris perform in his grunge heyday. I am so glad that despite frequently imbibing nearly the identical combination of meds found in his toxicology report, I am still here to rock out to and revel in his tortured genius, his swan songs; that, as Eddie Vedder triumphantly bellowed through the pouring rain at that same Lollapalooza in 1992, I’m still alive.
I just wish Chris Cornell were still alive too. Oh but do I deserve to be / Is that the question? / And if so, if so / Who answers?