Burrett, Constance Ann

38y · Female·Hypoxic ischaemic encephalopathy due to cardiorespiratory arrest caused by mixed drug toxicity (heroin and methylamphetamine overdose)

Constance Burrett, 38, died from mixed drug toxicity (heroin and methylamphetamine overdose) causing hypoxic ischaemic encephalopathy and cardiorespiratory arrest. The coroner found it more likely than not that her partner Justin Witsen injected her with heroin at her request, after she had difficulty self-injecting due to poor venous access. She had longstanding intravenous drug use and depression. Clinically, this case highlights: (1) the vulnerability of patients with difficult venous access to rely on others for drug administration; (2) the potent combined effects of heroin and methamphetamine; (3) risk stratification in patients with substance use disorder and mental health comorbidities; and (4) recognition that even experienced users can misjudge lethal doses. There was no indication of medical system failure—this was a community-based accidental overdose.