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.
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.