Brett Chidester was an American teenager who took his own life on 23rd January 2006 after he enclosed himself in a tent and lit a charcoal grill. He died of carbon monoxide poisoning. His death has been controversially linked to his prior experimentation with the psychoactive herb Salvia divinorum.

On 2nd May 2005, Senate Bill 259 (aka "Brett’s Law"), sponsored by Senator Karen Peterson, was issued in in Delaware, classifying Salvia divinorum as a Schedule I controlled substance.

Senator Karen Peterson and Brett’s parents Kathy and Dennis Chidester, in maintaining the belief that Salvia divinorum played a major role in Brett’s death, have subsequently continued to campaign for and support the strictest Schedule I legislation beyond their home state of Delaware [1].

Other US states, including Tennessee (HB2909/SB3247), Oklahoma (HB2485), Alaska (SB 313) and New Jersey (S1867) [2] are following suit with proposals for their own individual legislations.

Possible contributory factors

Suicide is currently the third leading cause of death amongst 15-24 year olds in the US. The suicide rate for white males aged 15-24 has tripled since 1950 (source: National Center for Health Statistics, American Foundation for Suicide Prevention).

Contributory factors underlying any individual suicide may be complex and not simply reducible to a single cause. With this in mind, it is worth considering further lifestyle and behavioural aspects along with any relevant research findings which may have a bearing.

Alcohol

There is no evidence that Brett used alcohol signigficantly, including absinthe, which has a proof generally higher than whisky. fuseaction=messageboard.viewThread&entryID=11888008&groupID=102049515&adTopicID=23&Mytoken=D00E16F2-AD8C-1019-632A11905A5C360220251418]

A user on these pages, indicating herself as his aunt [3], has also suggested that absinthe, imported from Czechoslovakia, was in fact Brett’s "drug of choice" [4]. This drug of choice was bought once in England, June 2006. When it was done, he was unable to purchase more.

Alcohol Concern’s suicide briefing includes the following points:

Alcohol and suicide: The research evidence

People who are alcohol dependent or problem drinkers are more likely to commit suicide than those who are not. Alcohol is also frequently consumed by non-dependent drinkers prior to suicide. The following research findings broadly demonstrate the significant connection between alcohol and suicide:

15-25% of suicides are associated with alcoholism (Gunnell & Frankell 1994)
Alcohol may be a factor in as many as 65% of suicide attempts (DoH 1993)
An American study found that 33% of the 806 suicide victims in Erie County (New York state) between 1972 and 1984 had alcohol in their blood (60% of these had a blood alcohol concentration of 0.10% or more) (Welte et al. 1988)
An international comparison found a clear association between alcohol consumption and suicide in 9 out of 13 countries studied (Lester 1995)
A Norwegian study found the relative risk of suicide among male alcohol misusers to be 6.9 (Rossow & Amundsen 1995). In other words, the risk of suicide is seven times greater among alcohol misusers than non-problem drinkers. The lifetime risk of suicide (before the age of 60) was estimated at 0.63% for those not considered alcohol misusers and 4.76% for those classified as alcohol misusers (Rossow & Amundsen 1995)

Why are problem drinkers a high suicide risk?

A number of factors probably contribute to suicide risk for problem drinkers. There are several theories to explain the significant role of alcohol in suicide, including:

Alcohol is being used as "self-medication" to relieve depression or other psychological problems that eventually lead to suicide (Murphy et al. 1992; Kendall 1983)
Alcohol misuse may be part of the social disintegration that often accompanies suicide (Yang 1992). Alcohol dependence often leads to social decline, including marriage break-up, loss of job and family ties. The resulting social isolation may be a potent cause of suicide (Kendall 1983)
Alcohol misuse may lead to loss of self-esteem and hence to depression. These psychological changes may predispose someone to suicide (Kendall 1983)
Intoxication produces increased impulsiveness and a weakening of normal restraints against dangerous behaviour (Kendall 1983; Rossow 1996; Zeichner et al. 1994)
Alcohol may increase the lethality of overdoses and sedative drugs (Kendall 1983)
Some people may be suicidally inclined from an early point in life, but seek comfort, relief or escape in alcohol as the first choice, and in suicide next (Rossow 1996)

On April 20th 2006 Mothers Against Drunk Driving and Nationwide Mutual Insurance Company announced Gallup survey results on underage drinking. The results highlight a major public misperception regarding the severity of teen alcohol use. "The survey results show that the public mistakenly thinks the youth drug problem is worse than the youth alcohol problem, despite research and statistics that show more youth are drinking and dying due to alcohol than all other illicit drugs combined." - Glynn R. Birch, MADD national president. [5]

Brett Chidester's death was reported locally by Delaware Online [6] and subsequently by a number of media outlets including CNN (links below), NBC [7], ABC [8], USAToday [9], W*USA 9 [10], KATV(Channel7) [11] and KXAN [12]. None of these or any other media stories on the issue have mentioned Brett’s alcohol use, all instead focusing on Salvia divinorum.

Salvia divinorum

Over three months after Brett's suicide, with no evidence of any trace of salvinorin being found in Brett's system, Delaware’s deputy chief medical examiner, Dr. Adrienne Sekula-Perlman, altered Brett's death certificate and added Salvia divinorum use as a contributing cause of his death (the immediate cause remains carbon-monoxide poisoning). She has subsequently refused to comment on her decision. [13]

It is difficult to determine how much Salvia divinorum really contributed to the death of Brett Chidester and the association with his suicide has been widely debated.

Contrary to some news reports, Brett’s suicide note did not mention Salvia. Brett had written earlier diary / journal entries about his experiences. Some media stories have presented these as if they were written just prior to his death. In his earlier writings he wrote:

"Salvia allows us to give up our senses and wander in the interdimensional time and space,... Also, and this is probably hard for most to accept, our existence in general is pointless. Final point: Us earthly humans are nothing."

Further context is lacking however as his journals have not been fully published. [14]

While it have been alleged that the use of Salvia divinorum may have triggered in Brett a depressional reaction leading to suicide, anectodal information suggests that Salvia divinorum acts instead as an anti-depressant. [15]

Furthermore, Salvia divinorum is considered relatively non-toxic (no lethal doses are known), non-addictive, short-acting (its effects lasting few minutes), with no significant deleterious long-term side-effects.

There have been no other reported cases of Salvia divinorum related suicides (or accidental deaths) anywhere else in the world. It may be argued that this simply reflects Salvia’s relative obscurity, however, a simple Google search of 'Salvia divonorum' returns ~1,500,000 results[16] which is suggestive of Salvia’s fairly significant profile and repute.

Due to the short acting effect of Salvia divinorum, lasting only few minutes, it is unlikely that Brett was under the direct influence of the drug when he committed suicide.

Brett's parents knew he had experimented with Salvia divinorum and asked him to stop. He said he would discontinue using it, so it is uncertain if he was still taking the herb before his death. [17]

Reports have not suggested in what form Brett took Salvia divinorum. A concentrated preparation of the leaf called Salvia extract, with relative strength suggested by terms such as 5x, 10x, 20x, even 40x, can be smoked in place of untreated leaves. It has yet to be established whether Brett was using natural leaf or a higher potency extract (and, if an extract, at what strength), or indeed if he was using any other form such as Salvia tincture.

Acne

Brett was suffering from acne which has a general association with depression and thoughts of suicide [18][19] [20][21]. To treat his acne, Brett was also taking minocycline which can have side effects that may impair thinking or reactions, including visual disturbances and confusion. [22][23]

General depression

Brett's parents have conceded that he may have anyway been suffering from general depression. [24]

External links

[scotland.co.uk/mediastories/government/brettslaw/index.htm Salvia Divinorum Sc