See my other comment in this thread. You are UNDERcalculating how much fent he had to take to get those blood levels in his body. Fent volume of distribution is about 4L/kg, not just total L of blood.
Also, oral fent bioavailability is only 33%, so what was in his body was only 1/3 of what he took.
Moreover, if those blood levels were free fent (ie not protein bound) then it would be even more, since fent is 80-85% protein bound.
I'm not undercalculating that, I'm not calculating it at all - I'm barely even speculating about it.
We have good reasons to believe that the fentanyl in his blood was fairly evenly distributed, so we can take a random sample and extrapolate from that to the amount that was in his blood. Just his blood.
We also know that 2 to 3 milligrams is considered to be a fatal dose (or at least potentially fatal). But that is 1 to 3 orders of magnitude higher than the implied mass of a known-fatal blood concentration. So clearly something is happening in between, but we really don't know what.
Around 99% of the pill is not-fentanyl. A few percent was meth. Probably 95% or more was a relatively inert excipient, but I didn't hear the lab lady say which one. If this was a "real" pill, it would probably be a member of the carbopol family, which would give a time release action. Presumably, some of the fentanyl would be destroyed by the digestive system, and some part of it would diffuse into the blood. And then some organs would take it up from the blood and give some back later, as the relatively molarity of the tissue and the blood varied. And a fraction would be metabolized and the metabolic byproducts picked up for excretion.
Even something as simple as this quickly turns into a tangled web of differential equations chasing each other. Lotka-Volterra on crack.
P.S. The main point of my previous post was "keep track of zeros because 1000 nano-X isn't 1 milli-X"
See my other comment in this thread. You are UNDERcalculating how much fent he had to take to get those blood levels in his body. Fent volume of distribution is about 4L/kg, not just total L of blood.
Also, oral fent bioavailability is only 33%, so what was in his body was only 1/3 of what he took.
Moreover, if those blood levels were free fent (ie not protein bound) then it would be even more, since fent is 80-85% protein bound.
I'm not undercalculating that, I'm not calculating it at all - I'm barely even speculating about it.
We have good reasons to believe that the fentanyl in his blood was fairly evenly distributed, so we can take a random sample and extrapolate from that to the amount that was in his blood. Just his blood.
We also know that 2 to 3 milligrams is considered to be a fatal dose (or at least potentially fatal). But that is 1 to 3 orders of magnitude higher than the implied mass of a known-fatal blood concentration. So clearly something is happening in between, but we really don't know what.
Around 99% of the pill is not-fentanyl. A few percent was meth. Probably 95% or more was a relatively inert excipient, but I didn't hear the lab lady say which one. If this was a "real" pill, it would probably be a member of the carbopol family, which would give a time release action. Presumably, some of the fentanyl would be destroyed by the digestive system, and some part of it would diffuse into the blood. And then some organs would take it up from the blood and give some back later, as the relatively molarity of the tissue and the blood varied. And a fraction would be metabolized and the metabolic byproducts picked up for excretion.
Even something as simple as this quickly turns into a tangled web of differential equations chasing each other. Lotka-Volterra on crack.
P.S. The main point of my previous post was "keep track of zeros because 1000 nano-X isn't 1 milli-X"