title: Fatal anoxia due to rachacha consumption: Two cases reported.
abstract: Deaths due to ingesting rachacha, which is a homemade paste obtained by decocting poppy heads, are very rare. No fatalities have been recorded in scientific publications. This product is not considered to be very dangerous by its users. We are reporting the first deaths (a 30-year-old man and a 28-year-old woman), after ingesting rachacha balls and alcohol consumption during an evening with a friend. Signs compatible with acute anoxia were observed during autopsy. Toxicological analyses highlighted the presence of morphine and codeine in the blood, urine and bile, with an absence of 6-acetylmorphine. Concomitant consumption of alcohol certainly played a role in the occurrence of death. The black paste found at the scene was identified as rachacha. The mean of consumption (orally) was confirmed by the presence of morphine and codeine in the gastric contents of both victims. The analysis of hair samples was performed to reveal the substance consumption history. Therefore, a possibility of contamination by sweat and/or putrefactive liquids in the post-mortem period must be considered for the interpretation of the results. These two cases show that taking rachacha can be dangerous, especially when combined with the consumption of substances which could potentiate respiratory depression induced by morphine.
authors.affiliation: Pharmacology and Toxicology Department, University Hospital of Nantes, 9 Quai Moncousu, 44093 Nantes cedex, France. Electronic address: catherine.ganiere@chu-nantes.fr.
authors.forename: Catherine
authors.initials: C
authors.lastname: Monteil-Ganiere
authors.affiliation: Biological and Forensic Toxicology Unit, Pharmacology and Toxicology Department, University Hospital of Limoges, 2 Avenue Martin Luther King, 87024 Limoges cedex, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Gaulier
authors.affiliation: Institut de Recherche Criminelle de la Gendarmerie Nationale, 1 boulevard Théophile Sueur, 93111 Rosny sous Bois cedex, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Chopineaux
authors.affiliation: Forensic Medicine Department, University Hospital of Nantes, 9 Quai Moncousu, 44093 Nantes cedex, France.
authors.forename: Lucia
authors.initials: L
authors.lastname: Barrios
authors.affiliation: Pharmacology and Toxicology Department, University Hospital of Nantes, 9 Quai Moncousu, 44093 Nantes cedex, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Pineau
authors.affiliation: Pharmacology and Toxicology Department, University Hospital of Nantes, 9 Quai Moncousu, 44093 Nantes cedex, France.
authors.forename: Éric
authors.initials: É
authors.lastname: Dailly
authors.affiliation: Forensic Medicine Department, University Hospital of Nantes, 9 Quai Moncousu, 44093 Nantes cedex, France.
authors.forename: Renaud
authors.initials: R
authors.lastname: Clément
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D001569:Benzodiazepines / Q000097:blood; D000078306:Clobazam; D003061:Codeine / Q000097:blood; D005260:Female; D035263:Flowering Tops; D053593:Forensic Toxicology; D006801:Humans; D000860:Hypoxia / Q000139:chemically induced*; D008297:Male; D009020:Morphine / Q000097:blood; D010207:Papaver / Q000506:poisoning*
chemical_list: D001569:Benzodiazepines; D000078306:Clobazam; D009020:Morphine; C024581:N-desmethylclobazam; D003061:Codeine
keywords: Anoxia; Morphine; Poppy heads; Rachacha; Respiratory inhibition