Experts: Roy Halladay likely impaired at time of fatal plane crash

The combination of drugs in the system of Roy Halladay indicate the two-time Cy Young winner likely was impaired at the time of his fatal plane crash in November, three veteran pathologists told USA TODAY Sports.

Halladay had high concentrations of morphine and amphetamine along with the presence of an antidepressant, the sleeping aid zolpidem (sold under brand name Ambien) and trace amounts of alcohol in his blood, according to the autopsy report released by the Pinellas-Pasco Medical Examiner’s Office on Friday.

The forensic experts told USA TODAY Sports that the high levels of morphine, amphetamine and Ambien were the most worrisome.

“He had a drug combination similar to a speedball,” forensic pathologist Burr Hartman, who has nearly 40 years of experience in the field and serves as an expert witness in forensic pathology and toxicology, told USA TODAY Sports in a phone interview. “He was impaired by these drugs. It was definitely not safe for him to fly an airplane.”

A speedball, in street drug parlance, is typically a mixture stimulant (in many cases cocaine) and depressant (typically heroin or morphine). Such combinations have been a major factor in the increase of drug-related deaths in the USA.

William A. Pellan, the director of investigations for the medical examiner’s office, told USA TODAY Sports that the morphine in Halladay's system was "likely an opiate for pain." Hydromorphone, a narcotic pain reliever marketed under the name Dilaudid, was found in Halladay's blood, according to the toxicology report.

Pellan said his office was “responsible for determining cause and manner of death” and whether he was impaired “would not be under the purview of the medical examiner to determine.” That determination would have to to come from the National Transportation Safety Board, Pellan said.

NTSB spokesperson Terry Williams told USA TODAY Sports on Friday the investigation is still pending. Pinellas County Sheriff's Office spokesperson Kevin Doll declined to comment on Halladay's potential impairment at the time of the crash.

The use of "any drug that affects the person's faculties in any way contrary to safety" is prohibited when operating a civil aircraft, according to FAA regulations. The FAA also forbids the consumption of alcohol within eight hours of piloting a civil aircraft.

Howard University pharmacology professor Robert L. Copeland said the drugs found in Halladay’s body certainly raised “impairment concerns,” even if he had built up a tolerance to the drugs.

Adel Shaker, an Alabama-based board certified anatomic and forensic pathologist with 30 years of experience, told USA TODAY Sports that even if Halladay had developed a tolerance to the drugs over the course of several years, the combination of drugs most likely would have affected him.

“The synergetic action of zolpidem and free morphine will have a depressant effect on the central nervous system affecting the ability to operate a machine unless tolerance is put into consideration in case of chronic use,” Shaker said.

Shaker added tolerance, however, doesn’t mean Halladay was unaffected by the drug combo. The antidepressant fluoxetine (Prozac) also found in blood sample taken at the time the autopsy was performed could have slowed down Halladay’s metabolism, Shaker said.

After reviewing the report, Hartman said the high levels of amphetamine in his system - which could have come from the the attention-deficit/hyperactivity disorder (ADHD) drug Adderall - "fit the definition of abuse." Hartman also said Halladay had a “considerable” amount of morphine in his system.

“It’s a cocktail that could have led to cardiac arrest, but it would have also impaired his coordination,” said Hartman, who is based in Northern California.

Halladay, who won 203 games in a 16-year career, retired in 2013 after his final two seasons were plagued by shoulder problems. He underwent surgery to repair a partially torn rotator cuff and frayed labrum in May 2013, but was ineffective upon his return in August.

"It was tough," Halladay said at a December 2013 press conference announcing his retirement. "To be able to go out there and know that it's probably not going to feel very good and I'm probably not going to be able to do things the way I want to is very frustrating."

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