A 19-year-old male died from mixed drug toxicity following ingestion of illicit methadone and diazepam. He was a regular user of illicit substances and prescription medications obtained without medical supervision. He had anxiety managed by a GP with Zoloft, but missed follow-up appointments. On the evening of 9 July 2018, he obtained diazepam and methadone from an illicit supplier. Friends observed he was significantly drug-affected that evening. He died in his sleep from combined respiratory and cardiac depression caused by the synergistic effect of benzodiazepines and opioids. Clinical lessons include recognising substance use disorder as a serious medical condition requiring structured treatment, maintaining engagement with at-risk young people through follow-up care, and understanding the lethal combination of benzodiazepines and opioids. Better mental health support and addiction services may have prevented this preventable death.
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