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1.) TRIPLE MAXIMUM LETHAL DOSE
EVEN FOR SEVERE ADDICTS:1.52 MG MORPHINE PER LITRE OF BLOOD
Cobain's death in April, 1994 led to wide media coverage, and it was soon revealed that his blood morphine level was 1.52 mg per litre (mg/L). One biographer mistakenly claimed that Cobain "injected" 1.52 mg of heroin. The figure 1.52 mg actually refers to the level of drugs found in Cobain's blood, not the amount he originally injected. This can be seen in other reports, both biographical and mass media, where the 1.52 mg level is sometimes further described as "per litre of blood" or "triple the lethal dose," usually with subsequent notes that an addict has higher tolerance. Cobain would have needed to inject much more than 1.52 mg of heroin to help even the most mild headache. Additionally, the Seattle Police Department reported that a cigar box of drug paraphernalia was beside the victim, including pieces of what appeared to be black tar heroin, generally regarded as Mexican in origin. Also, according to the Seattle Police Reports, two puncture marks were found on Cobain's body, one in each arm, in the inside crooks of the elbow region.

TOLERANCE HAS A WELL DEFINED LIMIT
The fact that there is "higher tolerance among addicts" is commonly misunderstood. This concept is evoked apparently as an attempt to describe how it could be remotely possible that Cobain was alive and functioning well enough to fire a shotgun, despite the otherwise triple maximum lethal dose. The "1.52 mg" figure refers specifically to the morphine per litre of blood. No doubt exists that a blood level of 1.52 mg of morphine per litre represents just a little bit over three times the maximum lethal dose, but the implications of this fact are not well understood.

WHAT IS THE LETHAL DOSE OF HEROIN?
Table 2, below, shows that the lethal dose range of intravenous heroin is generally regarded as 10 mg to 12 mg. Sometimes even a tiny dose can kill, so the lethal dose of intravenous heroin can go as low as 3 mg, possibly even lower. Some people get confused and think that high variability in the minimum lethal dose means that a similar variability exists for the maximum lethal dose. The most serious heroin addicts will die with virtual certainty with much less than a dose of 75 mg to 80 mg of heroin. After studying many hundreds of such cases, it is clearly established that 75 mg to 80 mg is the maximum lethal dose for even the most severe heroin addicts. Note that in a low tolerance person, in an average hospital setting, a small effective therapeutic dose of intravenous heroin is only 3 mg to 4 mg. The important thing to note here is that the problems associated with establishing a "lethal dose" for intravenous heroin primarily relates to the problem of establishing a "minimal lethal dose," i.e. the smallest amount of heroin which will kill. The "maximum lethal dose," i.e. the highest dose of intravenous heroin a severe heroin addict can withstand without immediately collapsing into a coma and/or immediately dying, is very well documented. The blood morphine level of 1.52 mg per litre found in Cobain's body represents a heroin dose which is substantially higher than this well established maximum lethal dose.

TABLE 2
Therapeutic, Toxic, & Lethal Dose Ranges of Intravenous Heroin in Relation to Low & High Tolerance Levels
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    Degree of Toxicity or Lethality Dose Range
      Therapeutic (low tolerance) 3 mg - 4 mg
Toxic (low tolerance) 3 mg - 10 mg
   Lethal (low tolerance) 10 mg - 12 mg
            Therapeutic (high tolerance) 10 mg - 60 mg
   Toxic (high tolerance) 10 mg - 70 mg
    Lethal (high tolerance) 75 mg - 80 mg
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Appendix A - Appendix B - References 1 / 2