Finding into death of Shayn Nathan Darmanin

43y · Male·Mixed drug toxicity (methadone, synthetic cannabinoids (5f-cumyl-pinaca and cumyl-pegaclone), olanzapine, duloxetine) in a man with epilepsy

Shayn Darmanin, a 43-year-old man with epilepsy, died from mixed drug toxicity involving methadone, synthetic cannabinoids, olanzapine, and duloxetine. He had a significant history of substance abuse, family violence offending, and mental health issues. His death was the unintended consequence of intentional drug use. Key clinical lessons include: recognising that synthetic cannabinoids carry significant risks including seizures, acute kidney injury, and myocardial infarction; understanding that patients with epilepsy who are inconsistent with medication compliance face increased risks; and ensuring adequate monitoring and support for vulnerable individuals in community settings. Better coordination between substance abuse services, mental health services, and primary care, along with patient education about synthetic cannabinoid risks, could have improved outcomes.