Quebec man’s death prompts coroner’s call to tighten controls on diphenhydramine sales

A tragic incident in December 2023 has prompted a Quebec coroner to recommend better management of diphenhydramine, an antihistamine and sedative, in pharmacies. The death of an 18-year-old man in St-Mathias-sur-Richelieu due to acute diphenhydramine poisoning has raised concerns about the uncontrolled availability of this potentially lethal over-the-counter substance.

The young man, whose identity has not been disclosed, was found unconscious in his bed by his mother on the morning of Dec. 11, 2023. Toxicological analysis revealed a fatal level of diphenhydramine in his blood. Diphenhydramine is commonly found in over-the-counter antihistamines such as Benadryl, among others.

Coroner Vincent Denault expressed bewilderment at the unrestricted availability of diphenhydramine, especially considering the risks associated with its toxicity. He highlighted the fact that similar medications like Gravol, which also contains diphenhydramine, are not available over the counter.

In his report released in late April, Denault attributed the man’s death to the acute toxicity of diphenhydramine, a central nervous system depressant that can cause fatal respiratory depression and irregular heartbeat. The coroner discovered empty jars and blister packs of diphenhydramine tablets in the man’s bedroom, raising questions about his usage patterns.

This tragedy is not an isolated incident, as Denault pointed out previous deaths linked to diphenhydramine. He mentioned a concerning trend around 2020, where social media challenges encouraged individuals to consume dangerous amounts of medication containing diphenhydramine for euphoric and hallucinogenic effects.

Denault’s recommendation includes reclassifying diphenhydramine intended for oral administration in a section that requires closer management by pharmacists. This would involve creating a file, documenting sales, and conducting pharmacological assessments. The coroner also urged collaboration with the Collège des médecins du Québec and the Ordre des pharmaciens du Québec to address this issue.

Jean-François Desgagné, president of the pharmacists’ order, stated that they would review the recommendation to potentially move diphenhydramine behind the pharmacist’s counter for better control and monitoring.

If you or someone you know is struggling, there are resources available to help. It is essential to address the risks associated with over-the-counter medications and work towards better regulation to prevent future tragedies like this one.