The Death of Ted Binion: Drug OD/Suicide or Murder by Poisoning – When the Average Means Too Much

Presented at: American Academy of Forensic Sciences, Last Word Society, Las Vegas, NV, February 19, 2004

On September 17, 1998, the body of Las Vegas casino owner Lonnie Theodore Binion was discovered by his girlfriend, Ms. Sandra Murphy, lying on the floor of his den. He was not breathing and did not respond to his name. “911” was called but Mr. Binion was beyond resuscitation. Ms. Murphy stated that she had last seen Mr. Binion asleep on the floor around 10 am that morning.

Mr. Binion had a long-time heroin dependency and he used to buy “black tar” heroin and smoke it on a piece of aluminum foil by heating the underside with a lighter, a technique called, “Chasing the Dragon”, because in old days in China the trail of smoke that evolved from the heated heroin looked like the “tail of a dragon”. Ms. Murphy also reported that Mr. Binion, when he smoked heroin would sometimes put the barrel of a handgun in his mouth. It was also learned that on the day before his death, Mr. Binion received a prescription for 120 tablets of 0.5 mg alprazolam (Xanax), from his physician. Around the mouth and lips was a patchy, slightly red discoloration (which did not resemble the shape or pattern of fingers), and pulmonary edema was present at autopsy, but no other evidence of significant pathology or trauma was apparent. Trauma to the face was described by one pathologist for the State as “due to vigorous cleaning to remove vomitus”, with which the pathologist expert for the defense disagreed, and due to “Burking”, a form of smothering, by a pathologist expert for the State, with which the pathologist expert for the defense again disagreed. An empty pill bottle which had contained alprazolam was found on the floor near the body, as was a piece of foil. The pathologist expert for the defense criticized the technique of the autopsy because the small intestines were not opened to look for residue of pills and/or heroin that might have been ingested orally.

Samples of peripheral and heart blood, vitreous humor, gastric contents, liver and lung tissue were collected and submitted for toxicology analysis. The State pathologist opined that, “Based upon observations that the body and death scene were tampered with, that the drugs which killed Mr. Binion were ingested in an atypical fashion, and that inconsistent accounts of events preceding and immediately following Mr. Binion’s death have been reported by the individual who discovered the body, it is my opinion that another person or persons were involved in the death of Lonnie Binion. The manner of death is therefore determined to be homicide.” The Clark County, NV Chief Medical Examiner determined the Cause of Death as follows: “It is my opinion that the decedent, Lonnie Theodore Binion death as a result of ALPRAZOLAM AND OPIATE INTOXICATION.” Manner of death: Homicide. Toxicology results were reported as follows:

Results of Toxicology Testing


Heart Blood*
Peripheral Blood*
Gastric Contents*
Vitreous Fluid*
Alprazolam (Xanax)
Sample site for Xanax not clear
Therapeutic levels of diazepam and metabolites were detected in blood

Key: *ng/ml; ** ng/g

Opinion of the State’s expert pathologist: murder by suffocation; Opinion of the defense’s expert pathologist: suicide due to alprazolam/heroin OD; Opinion of the author expressed on Court-TV: Murder due to forced ingestion of alprazolam and heroin, due to the additive effect on respiratory depression and some contribution from diazepam, all probably after smoking heroin. Facial erythema was most likely due to burns from hot smoke.

Key terms: Interpretation of published blood levels; Route of administration; Tolerance

Impact Statement: Specialized training in pharmacology/toxicology and attention to detail are required to avoid errors in the interpretation of post-mortem blood levels of drugs; Drugs administered by an atypical route are suspicious and can provide clues to the manner of death.