Man from Hove died after injecting mephedrone
A 46-year-old man from East Sussex died after injecting himself four times with the former legal high drug mephedrone, an inquest heard.
John Sterling Smith, had the second-highest concentration of the substance experts had ever recorded, but the inquest at Brighton was told it was "unlikely" that it alone killed him.
Pathologist Dr David Wright said Mr Smith had coronary artery disease.
Mr Smith died after suffering a cardiac arrest at his Hove home on 7 February.
The inquest at Brighton County Court heard Mr Smith, who worked as a a part-time sales assistant, was also HIV positive, suffered from chronic renal disease and high blood pressure and was a diabetic.
Dr Wright said it was "hard to know" if Mr Smith would have died if he had not had underlying health problems.
"To be honest I don't really think anybody does. I don't think anyone can absolutely say for certain," he added.
"It seems much more likely, I think, that perhaps it was the combination of mephedrone and the heart disease that led to him dying."
Mr Smith had spent the evening of 6 February at his home in The Drive, Hove, with two men, Christopher Sarson and Ian Turner.
They spent their time injecting themselves and each other with mephedrone and having sex, the inquest was told.
Mr Sarson said Mr Smith fell on to his side and started having some kind of seizure.
He added: "It was as though he was trying to breathe. We knew there was something wrong."
Mr Sarson said he started performing CPR on Mr Smith while Mr Turner called for an ambulance.
Mr Turner told the inquest: "I saw that John's lips had gone purple. He was gargling and he was trying to - he appeared to be clutching his chest."
He said this happened about an hour after Mr Smith had taken his last dose of mephedrone.
Sussex Police Det Sgt Steve French said the two men were arrested at the scene but were later stood down from bail without charge because none of the drugs were illegal at the time.
Mephedrone was made illegal on 16 April on the advice of the Advisory Council for the Misuse of Drugs.
Following Dr Wright's advice Brighton and Hove assistant deputy coroner, Dr Karen Henderson, changed Mr Smith's recorded cause of death from mephedrone poisoning to mephedrone poisoning in the presence of coronary artery disease.
She recorded a narrative verdict, and said: "Being legal does not mean being safe or benign and it would be my wish that these differences be known on a wider basis.
"It is my verdict that John died following injecting mephedrone repeatedly, causing mephedrone poisoning on the background of coronary artery disease."