Philip Seymour Hoffman died from drug cocktail, says medical examiner
Actor Philip Seymour Hoffman died accidentally from taking a combination of heroin, cocaine and other drugs, the New York medical examiner has ruled.
Hoffman, 46, was found on February 2 with a needle in his arm on the floor of his Manhattan apartment.
He had also had taken amphetamines and benzodiazepines, which are drugs such as Xanax and Valium that are widely prescribed for anxiety, insomnia and other problems.
Addiction experts say such a toxic mix is not uncommon in the tens of thousands of overdose deaths in the United States each year.
The medical examiner did not provide the names of the drugs or the amounts found in Hoffman's system, making it impossible to determine which drug was the major factor, said Dr Charles McKay, a medical toxicologist for Hartford Hospital in the US state of Connecticut and spokesman for the American College of Medical Toxicology.
"There's a difference between a stimulant death, which would be cocaine and the amphetamines, and a narcotic death, like heroin," he said.
The first two can cause heart rhythm problems, a stroke or heart attack, whereas heroin, especially with sedatives such as benzodiazepines, can depress breathing.
In any case, McKay said, the combination of drugs "suggests someone who has been using drugs repetitively".
Police had been investigating Hoffman's death as a suspected drug overdose. Tests found heroin in samples from at least 50 packets in his apartment.
Authorities also found unused syringes, a charred spoon and various prescription medications, including a drug used to treat heroin addiction, a blood-pressure medication and a muscle relaxant.
More than half of overdose deaths in the US involve a mix of drugs, said Dr Len Paulozzi, a medical epidemiologist with the Centres for Disease Control and Prevention. At least a fifth also involve alcohol, he said.
There were more than 38,000 recorded drug overdose deaths nationwide in 2010.