Confirmed: Las Vegas Shooter on Benzos

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I have previously reported that Stephen Paddock, the 64-year-old Las Vegas mass murderer, was given prescriptions for Valium some time prior to the shootings. This was the bloodiest rampage in U.S. history, but information has been sparse about Paddock.

A Las Vegas newspaper has now obtained and released the autopsy blood toxicology report for Stephen Paddock. Three metabolites (breakdown products) of Valium (diazepam) were found in his blood: nordiazepam 42 ng/mL; oxazepam 170 ng/mL; and temazepam 140 ng/mL. (Editor’s note: See correction at end of article; the metabolites were found in Paddock’s urine, not in his blood.)

What can we make of these findings?

This specific pattern of three metabolites is a marker that indicates that an individual has been recently using or abusing Valium (diazepam).

According to a paper about the toxicology of Valium, “Frequent or daily users of diazepam will commonly test positive for all three metabolites, which represents and should be recognized as the ‘textbook’ toxicology pattern of recent diazepam use.” Furthermore, “patients using diazepam on an infrequent or PRN basis may not exhibit the textbook pattern.”

Paddock’s autopsy report confirms he was a regular user of Valium, at least in the days leading up to the shootings.

It is also possible that these results could come from using a mixture of benzodiazepines, but that would be unusual and would not change the outcome. We do know he had prescriptions for Valium as reported in my earlier blog. Meanwhile, what we have is the typical toxicology report for a Valium user.

Can benzodiazepines cause or contribute to violence? The answer is a strong “Yes!”            Clinical experience and research going back decades recognizes the potential for benzodiazepines to cause violent behavior. In my book Medication Madness: the Role of Psychiatric Drugs in Cases of Violence, Suicide and Crime, I review the science and describe my own forensic cases in which benzodiazepine use has led to violence.

The FDA-approved Full Prescribing Information for drugs, also known as the package insert or label, is the most basic source of information on adverse drugs effects. The 2016 FDA-approved Full Prescribing Information for Valium states:

Psychiatric and Paradoxical Reactions: stimulation, restlessness, acute hyperexcited states, anxiety, agitation, aggressiveness, irritability, rage, hallucinations, psychoses, delusions, increased muscle spasticity, insomnia, sleep disturbances, and nightmares. Inappropriate behavior and other adverse behavioral effects have been reported when using benzodiazepines. Should these occur, use of the drug should be discontinued. They are more likely to occur in children and in the elderly. (bold added)

The official FDA-Approved Medication Guide is usually appended to the Full Prescribing Information. By law, the Medication Guide must be based on science and reflect basic information in the Full Prescribing Information.

In the Medication Guide for Valium there is a section headlined “Call your healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you.” Beneath that headline there are several bulleted warnings, including the following direct warning about “acting aggressive, being angry, or violent“:

  • acting on dangerous impulses
  • feeling agitated or restless or new or worse irritability
  • an extreme increase in activity and talking (mania)
  • acting aggressive, being angry, or violent or other unusual changes in behavior or mood (bold added)

The FDA clearly confirms that Valium can cause violence.

Why haven’t you already heard about these important toxicology findings? One reason is the headline on the original article that announced the autopsy toxicology findings. It reads, “Las Vegas shooter’s autopsy gives no clues.” But the lack of reporting on psychiatric drug-related mass violence is a national pattern. The story provided sufficient information implicating Valium for the media to have run with it.

I have been a medical expert in many legal cases revolving around violence caused or aggravated by psychiatric drugs including the Columbine mass murderer Eric Harris and the Aurora Theater mass murderer James Holmes. These and other cases are described on my website, www.breggin.com.

There is no doubt that many violent perpetrators have been driven wholly or in part by psychiatric drug effects. Once again we have a murderous atrocity perpetrated by someone taking psychiatric drugs. As far as we know, this individual had no history of psychiatric treatment or hospitalization, and no history of prior serious violence.

What role did Valium play in his evolving murderous plans and their perpetration? His complete medical and prescription records must be made public, along with every other shred of relevant information about the evolution of his violent plan and actions.

How many more people must die before this cover-up ends and society takes seriously the role of psychiatric drugs in so many of these tragic events?

*****

Correction on February 15:  My original report was based on a mislabeled table in a newspaper. I have now obtained the original coroner’s toxicology report on diazepam (Valium) and the reported metabolites were in the urine and not in the blood.   Similar to blood samples, these urine results represent a typical pattern following diazepam use and indicate that he was likely taking the drug in recent times within a window of 2-7 days earlier.  https://www.practicalpainmanagement.com/treatments/pharmacological/demystifying-benzodiazepine-urine-drug-screen-results   Diazepam and its metabolites were not found in the blood but the method would not have detected them at levels below 20 ng/mL. Given the significant levels in the urine of all three metabolites but not in the blood, Paddock was most likely under the influence of a recent exposure and/or withdrawal from Valium. 

 

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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42 COMMENTS

  1. Benzodiazepine withdrawal toxic psychosis can happen very quickly indeed, in-between taking doses. You literally go right out of any control… foot down on gas smashing into everything. None of us who have experienced this, would be in the slightest bit surprised. No doubt the MSM will cover it up or concentrate on illicit ‘dark web’ use ala the ‘guardian’ and ignore the obvious mass GP/psychiatrist prescriptions. They will interview and present the ‘experts’ who want to drug more ‘dangerous’ people in the ‘community’. Made dangerous by their own actions of drug prescriptions. They just can’t see their way out, other than to cover everything up and label us as Scientologists, nut jobs and the like…. ‘Mentally ill’ is a great cover up….so far. Pharmacogenetics will blow this out of the water. The trouble is the doctors/pharma are in control…so far….

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  2. Dear Dr Breggin,

    Thank you for your article. I have experience of “acting out ” on psychiatric drugs. Every hospitalization I had bar the first hospitalization was a suicidal event.

    No matter how badly I felt prior to going on psychiatric drugs my feelings were my own, and I could survive them. But under the influence of psychiatric drugs I was at least a danger to myself.

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  5. In my years in recovery from alcohol and Rx drugs going to AA and volunteering at a treatment center I have heard 100s of stories from completely normal people who did absolutely crazy S wile on benzos including bank robbery in that memory blacked out state. I believe that benzo induced insanity is what allowed this to happen. This guy likely had troubles and even thoughts of mass murder but in my option it was benzo insanity that lead to or “allowed” him to carry it out. It had to be.

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    • Soteria Israel

      “….A middle-aged, divorced father of two, he had suffered a psychotic break of sorts six weeks earlier while strung out on high doses of benzodiazepines. He had acted out aggressively at work, and by the time he arrived at Soteria, he was hearing voices and suffering extreme anxiety attacks. During his first days here, he often behaved in a threatening…”

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  6. “How many more people must die before this cover up ends and society takes seriously the role of psychiatric drugs in so many of these tragic events?”

    This is the question of the decade, if not the century. As long as the media fails to report on the direct connection between neurotoxic psychotropic drugs and the horrendous acts of violence, these tragic events will not only continue, but they will increase. Why? Think of how many more people there are now who are drugged up like Paddock, Harris, and Holmes. Remember Andreas Lubitz of Flight 9525 infamy? There are many others. Dr. Breggin’s book “Medication Madness” is an excellent book on this topic, and it shows how neurotoxic, psychotropic drugs can turn the mildest and most peace loving human beings into raving, violent lunatics. It’s a tragedy not only for the victims, but the perpetrators as well.

    Not everyone who takes these drugs turns violent, but the likelihood of violence is much stronger when neurotoxins are involved. Drug induced violence may be limited to oneself. Remember Robin Williams? Or it may extend toward others, as Paddock’s case demonstrates. See also: https://ssristories.org/

    Perhaps the pharmaceutical companies’ grip on the media prevents such honest reporting as we have here with Dr. Breggin’s commentary. Whatever the case, unless the media starts to tell the truth about psychotropic drugs, I can predict that we will witness many more of these atrocities.

    “How many more people must die before this cover up ends and society takes seriously the role of psychiatric drugs in so many of these tragic events?” Sadly, my guess is that many more people will die before the general public catches on to the truth about psychiatry.

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    • Exactly! Journalism used to be about truth. There were ethics about things like confirming an account from reliable sources rather than speculating, and also about following leads until you got to the nitty-gritty truth, not pulling your punches or avoiding the tough questions. I was reading Ronan Farrow’s article in the New Yorker titled My Father, Woody Allen, and the Danger of Questions Unasked the other day. Here’s the link: (https://www.hollywoodreporter.com/news/my-father-woody-allen-danger-892572). He discusses how journalists are told by their editors not to ask, not to pursue certain stories. He’s talking about sexual abuse and assaults, but the same thing is going on regarding the psych drugs’ role in all these killings. I remember in the late 80s and early 90s when ACT UP began outing gay politicians in order to get policy changes and funding for AIDS research. We need more courageous journalists like Robert who are willing to “out” these dangerous drugs as the real killers that forced the hands of the people in the mugshots.

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  7. with growing inequality and mass incarceration and a mean spirited, 0 tolerance culture, American society is fertile soil for the most oppressive sort of psychiatry imaginable. if anything, my best guess is that this case and others will be used by spin doctors to demand more funding for the “cruel compassion” of psychiatric “treatment,” for more and more people (voluntarily and involuntarily).

    of course…I don’t think its all doom and gloom. on and individual basis, even in small groups, families, etc., i think more people are waking up and will wake up to the truth. i just don’t expect anything good or worthwhile to come out of this at the higher levels.

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  8. Drugs tend to be dehumanizing agents. I had a 50 year career as a psychotherapist and found that it was necessary to get patients off of drugs in order to help them to express honest emotions and to recover.
    My mentor, Dr Donald Winnicott described the True Self, which came from the right brain and the body, and I found that this was the key to helping psychotic patients escape from the hell of mental illness.

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  9. I believe that in the mid 70’s Valium was the most prescribed drug in the US or the world, or something close. But the word “benzodiazepine” was not well known, certainly not to me. Valium was simply referred to as a “minor tranquilizer,” and could even be bought on the street. I occasionally found it useful for sleeping on long train rides but otherwise yuck, veggieland. It must be miserable stuff to be physically dependent on.

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  10. From what I’ve observed, many people who use benzos tend to lose their inhibitions very quickly and do many things that they wouldn’t do otherwise. I knew someone who used Xanax as a recreational drug. Without the Xanax this person was normally fairly uptight, rigid and very proper. When he got hold of Xanax he was a totally opposite person, doing very inappropriate things even in public. It was interesting to watch but hell to have to put up with his behavior until the damned stuff got out of his system.

    So, if you’re a person who bottles up your anger and is out of touch with your feelings I could see you doing something like this guy did upon taking benzos. It doesn’t surprise me at all.

    It’s disturbing how very little is ever said about all this. The mass shootings in schools and work places as well as other venues didn’t start happening until the damned SSRI’s showed up on the scene.

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    • Totally! SSRIs are prescribed to little kids for “selective mutism” or whatever they called it. I thought it was a sick joke when I first heard about it. I had a few kids who were “selective mutes.” Both times with the same teacher, a very tall, stern-looking woman. Even I found her a bit intimidating though she was definitely a nice person. But when I suggested that my daughter found the teacher a bit scary (I didn’t use that word), I was told it “couldn’t” be as she was such a nice teacher. yes, but…
      But some adults use the drugs specifically to reduce inhibitions, just like others would use alcohol. So basically what you seen to be saying (and I agree) is that the drugs don’t create something that wasn’t there before, they just enhance it, possibly millions of times. Could benzos take a truly nice decent person and turn them into a murderer? I really doubt it.

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  12. The latest news report I read and it is hard to even consider delving in-reports TRAUMA!
    He is an ORPHAN!
    The system failed him and all the ties that bind- the big Pharma playbook, the NRA change from times where assault rifles were not used or even thought about, the weapon industry – those who make money off of assault weapons, the Mental Health system which soon after deinstutionslization began to flounder because monies from the Federal government weren’t forthcoming and a divide and conquer mentality ran slipshod and wild fire over the disability movement especially seen between the DD and MH funding and publicity.
    Professionals in the helping fields became cogs in a more and more restrictive and push the pills work culture. Important information on Trauma was pushed and or erased so that the pills could or bogus therapies designed for submission could be used and touted.
    He in the eyes of the world was one of the EXPANDABLES.
    And he figured that one out.
    Until we all rise up
    Victims will be melded into Perps
    More people and children will die and ever so many people like in Thomas Grays “ Elegy in a Churchyard” will live lives at best of quiet desperation and those that had gifts unseen and unheard will never make their mark and help change the world.

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      • Many people are forced or tricked into taking those poisons. And horrible as the suffering is more than 99.9% of us don’t go on killing sprees. Suicide is more frequent, sadly. But you have to be a bit of an S.O.B. beforehand to do such a cruel horrible thing as go out mass shooting.

        Eric Harris from the Columbine shooting had records of being a selfish, entitled boy who refused to acknowledge the rights of others or his own moral responsibilities even at age 14. Presumably the drugging started later. Of course the drugs did not help.

        Unless you drug someone into a coma, no pills can prevent crime. Yet many are dumb enough to think you can transform Charles Manson into Gandhi by magical pills. Uh…no.

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  13. Of course responsibility is very important. There used to be a professional therapist who worked exclusively with adolescents who had murdered a parent. She never advocated for them to be absolved if the murder but worked within the criminal justice system. If and when able and allowed she would take them to the parent’s grave site.
    She understood the seeds of trauma but also comprehended hate and severe aggression is intolerable in a functioning society.
    And we all have to acknowledge there is a very wide spectrum on how humans have distinct temperaments and how each of us copes with trauma.
    I just get upset with the nomenclature used to avoid responsibility of the powers that be who avoid responsibility with the use of the phrase “mentally ill”.

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    • Actually I had confused you with “The Cat” first time around.

      I believe the primary function of prison should be to protect society from physically dangerous people and little else, certainly not revenge (this gets into arguments about “deterrence” however). It seems that fear of punishment/revenge is not a deterrent in the most horrific cases, whether triggered by drugs or anything else.

      During times such as this it should be an understood responsibility of us all to call talk radio, write letters to newspapers that will actually print them, etc. and alert them to the likely role of psych drugs, not “mental illness,” in these events.

      Two false scapegoats always raised in such cases are a) “untreated mental illness” and b) the very existence of guns. Both should be rejected.

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  14. Correlation is not causation. Clear thinking 101.

    If benzos are causing spree killings, why are spree killings not as common outside of the USA?

    I learnt today that it is federal law in the USA that anyone can purchase a semi-automatic firearm at age 18, and a handgun at 21.

    Seems a bit arse-backwards to an outsider. I also learned that individual states have their own stipulations. For instance, in Florida you can access all firearms at age 18.

    Your president said after the Las Vegas spree killing, that if the killer didn’t have access to 20th C. military-grade firearms, then he would have performed his spree killing using bombs instead.

    So again, if it woz the drugs wot done it, why aren’t spree killings on the rise outside the USA, including places where the notion of the-people-as-militia has long been put to bed as an artifact of history, and having no actual relevance in modern times?

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  15. Can anyone out there come up with a quick list of drug-related mass shootings, as specific as possible and including the drugs, that people could use when taking this issue to the media, etc?

    We need this kind of info on hand for when these things occur, so we don’t have to do lots of hurried research.

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    • would that help? Because these kinds of tragedies just draw the same lines over again – those who say “it’s the drugs” and those who say “it’s the inadequately treated mental illness.”
      I think other stories tell the truth better, like one i can’t recall where i saw it, a kid who killed his grandparents – who he loved – when on drugs, and said afterward that it was like he had no choice in the matter.
      in most (all?) of the school shootings, you get drugs making a problem worse (which is bad enough of course). but there are cases where the drugs invent the problem – that speaks more powerfully, to my mind.

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      • gabi taylor –

        You obviously have not experienced drug induced psychosis, akathisia, and toxic delirium all at once and looked totally normal.

        Children are toxic on these drugs because their metabolising enzymes are not fully developed and even if they were there is a good chance of still becoming toxic being as well all have different cytochrome P450 enzyme phenotypes, the drugs themselves inhibit the enzymes, and certain common food stuffs also inhibit the enzymes. So it can be as simple and tragic as a change of diet, change of drug, change of drug dose. And it goes off in the head. People on these drugs are primed to go off.

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