Yes, the ME stated that the fentanyl in Floyd's system was equivalent to that of a chronic pain patient. This is misleading because he didn't say which therapeutic dose he was referring to. It could be anywhere from 12 to 100 micrograms. Obviously the highest dose would be reserved for someone who already has an extremely high tolerance. I'm thinking the amount found in Floyd's system was closer to the starting dose. I don't think the jury has been swayed by the defense constantly bringing up the possibility of overdose. From the sound of it, they seemed much more interested in learning more about asphyxiation from neck and back restraints. Imo
I'm really trying to wrap my head around these drug concentrations and their significance.
My understanding is that therapeutic concentrations of fentanyl for analgesia (pain) would be 1-3 ng/ml nanograms (ng) per milliliter (ml) of blood. Mr Floyd had a level of 11 ng/ml in his hospital blood sample.
A level of 11 ng/ml is consistent with levels seen in fatal overdoses IMO
https://www.google.com/url?q=https:...FjAKegQIARAB&usg=AOvVaw0X9pBvKyWEL1v_BRlAmsqc
Multiple Fentanyl Overdoses — New Haven, Connecticut, June 23, 2016
I cannot find any traditional tablet version of fentanyl in the US, however, there are buccal (cheek), sub-lingual (under tongue) and transmucosal oral preparations available. The therapeutic dosages of these seems to vary on the exact drug delivery design, but I read of dosages between 100 and 1600 mcg.
Actiq, Fentora (fentanyl transmucosal) dosing, indications, interactions, adverse effects, and more
It seems that fentanyl patches have a much lower dose, but that is because they are dosed at mcg/HOUR. Therapeutic dosages are between 12-100 mcg/HR
Actiq, Fentora (fentanyl transmucosal) dosing, indications, interactions, adverse effects, and more
If one of the tablets from the Mercedes SUV was 0.397g and both the BCA expert Breahna Giles and the expert from NMS Labs, Susan Neith that the tablet(s) contained 1% fentanyl, that would be 0.00397g, or 3970mcg (IMO).
Assuming that 0.397g is an average weight of these tablets, and the 3 partial tablets found in the back of the squad car (ex 51, 52, 53) weigh a total of 0.297g (0.269+0.019+0.009 approx), then we can postulate that Mr Floyd may have consumed a minimum of 0.100g (0.397-0.297 = 0.100) of a tablet. If the agreed upon fentanyl potency is 1%, that = 0.001g or 1,000 mcg fentanyl.
If there were the remains of 2 separate tablets found in the back of the squad car, the amount of fentanyl consumed (by my calculations), could be even higher, up to 3700mcg, or even 4980mcg.
If that is correct, those values would be way higher than the highest therapeutic analgesia dose I have found, which is 1600mcg. Even 1,000 mcg is in the upper ranged of therapeutic dosages IMO.
It's conjecture at this point, but I wonder if it raises reasonable doubt.
I haven't even started on methamphetamine yet.
Let's hope I'm never on a jury!
Edited several times for clarity, grammar and to show my math working. Brain is now frazzled for the evening!