Post Mortem | The Rx Defense

Summary

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48 Hours: Post Mortem | The Rx Defense

Host: Anne-Marie Green
Guest: CBS News Correspondent Tracy Smith
Air Date: February 10, 2026

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Episode Overview

This episode of "48 Hours: Post Mortem" dives into the sensational and troubling case of 17-year-old Connor Hilton, who shot two of his friends—Ethan Riley and Benjamin Bleak—in his Texas home during a scheduled hangout on December 23, 2023. While Ben survived the attack, Ethan died in the hospital. The case attracted national attention when Connor’s defense argued that side effects from his acne medication, Accutane (isotretinoin), drove him to commit the act—an argument both unprecedented and highly controversial. Host Anne-Marie Green and correspondent Tracy Smith unpack the unique defense, the science behind the claim, the families’ devastation, and the aftermath for all involved.

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Key Discussion Points and Insights

1. The Unusual Accutane Defense

• Introduction to the "Rx Defense":

  • Connor’s lawyers centered their strategy around his prescription for Accutane, suggesting the medication’s side effects—specifically, altered thought and behavior—compelled his violent actions ([00:20]-[01:55]).
  • “I never heard of anyone being driven to kill because of [Accutane].” - Anne-Marie Green ([01:36])

• Accutane’s Known Side Effects:

  • Smith confirms the drug’s label warns of depression, psychosis, suicide, and violent or aggressive behaviors, though successful criminal defenses on these grounds are rare ([01:55]-[02:41]).
  • “As a mom, I know kids who’ve been on Accutane…a lot of people are on this drug and don’t suffer any severe adverse reactions.” – Tracy Smith ([02:12])

• Expert Testimony and Science:

  • Defense expert Dr. Doug Bremner presented research and brain scans purporting reduced activity in emotion-regulating brain areas in patients on isotretinoin ([02:47]-[03:45]).
  • Connor admitted to Dr. Bremner he doubled his prescribed dose on the day of the shooting.

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2. Investigating Red Flags and Pre-Attack Behavior

• No Warnings from Parents, Growing Concerns:

  • Connor’s parents denied seeing behavioral red flags, but police and friends noted troubling incidents ([03:45]-[05:43]).
  • Example: A friend recalled Connor recently asking, “Have you ever thought about killing one of your friends?” ([04:29])
  • Connor’s social media expressed a fascination with murder, with two anonymous reports made to his school months earlier; school found no threat.

• Timeline and Causality:

  • The question remained whether Connor’s fixation on violence began before or after starting Accutane; defense argued it followed the prescription, while prosecution refuted any cause and effect ([05:30]-[05:43]).

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3. Evaluating the Defense and Connor’s Persona

• The Prosecution’s Standpoint:

  • Prosecutors highlighted recent studies failing to connect isotretinoin to increased risk of suicide/psychiatric conditions; they dismissed Connor’s actions as evil, not medicated madness ([05:49]-[06:40]).

• Smith’s Interview with Connor:

  • Connor was extremely polite and hesitant during his pre-plea interview, rarely commenting on the specifics ([06:40]-[08:02]).
  • Notable Quote:
    • “I never hated them. I never hated him.” – Connor Hilton about his victims ([07:48])
  • Emotional moment: Connor paused for a water break, then asked Smith if she was okay ([08:25]-[08:39]).
    • Smith: “I’ve never had someone say that to me in an interview before.” ([08:40])
  • Detective and bodycam footage noted similar extreme politeness after the incident.

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4. Focus on the Victims

• Tragic Aftermath:

  • First responders arrived to find both victims shot in the head but alive; Ethan died later Christmas Eve as Connor was released on bond ([10:30]-[10:55]).
  • Ethan remembered as “full of love and light” by family and friends ([11:38]).

• Revelation of Ben’s Survival:

  • Ben’s unexpected appearance in the episode: “walking miracle.” His mother recounts moments that reassured her Ben’s humor had survived ([12:13]-[12:46]).
  • Ben has no memory of the shooting but adamantly rejects Accutane as a factor, labeling the defense “horseshit” ([13:13])
  • “He doesn’t mince words. It’s a little bit of his humor, too, there.” – Tracy Smith ([13:15])

• Impact on Recovery:

  • Ben, the oldest of the group, was already in college and had to relearn basic functions after his injury. His mother describes the process as “like having a baby again” ([13:31]-[14:05]).
  • Re-acclimating to life: Ben’s goal is to dunk a basketball again ([16:19]-[16:31]; see Quotes below).

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5. Guilty Plea and Sentencing

• Plea Deal Details:

  • Two weeks before trial, Connor took a plea: 50 years for murder and aggravated assault; eligible for parole in 25 years ([14:05]-[15:45]).
  • Smith explains the risks and rarity around such a plea, noting Connor later regretted it but had formally waived rights to trial and appeal.

• Victim Impact Statement:

  • Ben addressed Connor at sentencing, declaring he would never forgive him for the harm caused ([15:45]-[16:07]).

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6. Reflection and Broader Takeaways

• Ben’s Perspective on Resilience:

  • When asked what keeps him going:
    • Notable Quote:
      • Anne-Marie: "What do you want to be able to do?"
        Ben: "I know it sounds dumb, but I want to dunk a basketball." ([16:31]-[16:40])
  • Despite residual speech and mobility challenges, Ben’s spirit and humor shine; pickleball emerged as a key part of therapy and recovery ([17:14]-[17:51]).

• Parenting in the Digital Age:

  • Both host and guest reflect on the importance of parental vigilance over teenagers’ online activities and mental health ([17:51]-[18:40]).
    • “Sometimes we need to be the parent and not the friend and say no.” – Tracy Smith ([18:27])

• Closure and Unanswered Questions:

  • The host expresses relief the families avoided a protracted trial but curiosity about the viability of the "Rx Defense" in court ([18:40]-[19:00])

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Notable Quotes & Memorable Moments

• “I never heard of anyone being driven to kill because of [Accutane].”
  – Anne-Marie Green ([01:36])

• “There was no argument?”
  – Tracy Smith ([07:53])
  “No, ma’am.” – Connor Hilton ([07:54])

• “Are you okay? Am I not, like, freaking out or anything?”
  – Connor Hilton to Tracy Smith ([08:25])

• “Full of love and light.”
  – Ethan Riley’s father, describing his son ([11:38])

• “In fact, he called it. He called the defense horseshit.”
  – Anne-Marie Green quoting Ben ([13:13])

• “I know it sounds dumb, but I want to dunk a basketball.”
  – Ben, on his post-injury goal ([16:31])

• “Sometimes we need to be the parent and not the friend and say no.”
  – Tracy Smith on parental vigilance ([18:27])

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Timestamps for Key Segments

• Unique Accutane Defense: [00:20]-[03:45]
• Behavioral Red Flags & Social Media: [03:45]-[05:43]
• Evaluating Defense & Connor’s Interview: [05:49]-[09:15]
• Victim Impact & Family Memories: [10:30]-[13:31]
• Aftermath for Ben: [13:31]-[14:05]; resuming [16:07]-[17:51]
• Plea Deal and Sentencing: [14:05]-[15:45]
• Reflection on Parenting: [17:51]-[18:40]
• Closing Thoughts: [18:40]-[19:00]

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Summary prepared for those seeking an in-depth understanding of the Connor Hilton case and the viability—and fallout—of the controversial “Rx Defense.” The podcast provides not only a legal analysis but emotional depth through survivor stories and thoughtful reflection on issues of teenage mental health and modern parenting.

Transcript

[A]

Foreign.

[B]

Welcome back to postmortem. I'm your host Ann Marie Green. And today we are discussing the case of 17 year old Connor Hilton, who shot two of his friends, Ethan Riley and Benjamin Bleak, after they arrived at his home in Texas for scheduled hangout on on December 23, 2023. Ben miraculously survived, but when Ethan died in the hospital, Connor was charged with murder and aggravated assault with a deadly weapon. And his defense that he was on a prescription acne medication called Accutane that completely altered his thoughts and behavior. So joining me today to talk about this fascinating case is CBS News correspondent Tracy Smith. Tracy, thank you so much for joining us.

[A]

Hi, Anne Marie. Thanks for having me.

[B]

I wanna remind the listeners, if you haven't listened to this 48 Hours episode, the audio version, head on over to your podcast feed. You can find the full audio version just below this episode in the feed. Go take a listen and then come on back for this conversation. All right, Traci, let us get into this very unique defense strategy. Connor's defense team found an expert in isotretinoid, which is the generic version of Accutane. And through this expert, Connor's defense team argued that Connor was driven to kill due to the side effects of Accutane, which the expert says caused Connor to have a recurrent homicidal ideation that he simply wasn't able to control. Now, I know that Accutane comes with side effects and sometimes those side effects can be, you know, quite powerful, but I never heard of anyone being driven to kill because of it.

[A]

Yeah, I hadn't heard of it either. If you look at the label, the label does warn of risk of depression, psychosis, suicide, and aggressive or violent behaviors. And there have been other homicide cases that people have tried to use Accutane as a defense, but none of those have been successful. As a mom, I know kids who've been on Accutane, and it's a wonder drug for a lot of teenagers who struggle with acne. And a lot of people are on this drug and don't suffer any severe adverse reactions. And we did reach out to JG Pharma about this case and they did not respond to our requests for comment. They are the folks who distribute the Accutane that Connor Hilton was on at the time of the shooting.

[B]

So then let's talk about the science that the defense's expert presented. What do we know about it?

[A]

The Defense's expert is Dr. Doug Bremner, and he's a professor of psychiatry and radiology at Emory University School of medicine. And Dr. Bremner says he, he's done extensive research on the drug isotretinoin, which is the generic version of Accutane. He showed these brain scans where he says you can see the difference between the brain without isotretinoin and then the brain when someone is on isotretinoin. The scans show that there's less activity in part of the brain that regulates emotions when a person is on isotretinoin. And according to Dr. Bremner, there are a large number of people who have psychiatric effects when they are on isat retinoid. And he believes that in Connor's case, he was suffering from a medication psychotic disorder at the time of the shooting. And it's important to note that Connor told Dr. Bremner that on the day of the shooting, he took double the prescribed dose of his acne medication.

[B]

Okay, so here's the thing, though. He had been taking this medication for a while. You spoke to his parents and you asked them whether or not they had seen any red flags in terms of his behavior. They didn't see any. Did anyone else see red flags?

[A]

Yeah, they said they didn't. But the police spoke to his friends. I spoke to Ben and his friends said that that gun was out at the house all the time. It was not locked up where it was supposed to be. And he also said concerning things. There's one story that Detective McCandless and also Ben's mom Shannon told me that a week before the shooting, the 15 year old who was hiding in the bathroom on the night of the shooting, a week before the shooting, Connor had invited all of his friends over to watch a movie and the kids didn't want to watch a movie. And this 15 year old was sitting with Connor and Connor turned to him and According to the 15 year old, Connor said, have you ever thought about killing one of your friends? There are also social media posts that Connor had made that showed a fascination with murder. And in fact, his school received two anonymous reports from the same person about eight months before the shooting about these social media posts about murder. And they called in Connor's mother, they talked to Connor, they investigated, and they determined that there was no threat. We dug into the timeline a little bit just to try to figure out if this fascination with murder happened after Connor went on Accutane. And he did struggle with anxiety. But prior to going on Accutane, he didn't want to go to school. But Connor said this fascination with murder happened after he was on Accutane. Now, does that mean that There's a cause and effect here. The prosecution says, absolutely not. Acne medication has nothing to do with this horrific act that Connor committed.

[B]

You know, Tracy, as I was watching the hour, that's kind of like one of the things that I was going back and and forth with.

[A]

Right.

[B]

I. I know that. That there can be experts to argue almost anything, but expert that, you know, perhaps Accutane could have had these dire side effects. What I wasn't sure of was whether or not that could be a defense. And the prosecution sort of basically argued that too. In fact, they argued against the science in court. The prosecution introduced a more recent study that found that I saw retinoid generic Accutane. That those users actually do not have increased risk of suicide or psychiatric conditions. And then the lead prosecutor told you that this case is simple. What she believes is that it's not a side effect from medication, that some people are just evil. You sat down with Connor for an interview. I'm curious. I mean, how did he come across to you?

[A]

You know, we talked to him right before he took the plea. At that point, when we spoke to him, he thought he was going to trial. So he, at the advice of his attorneys, didn't talk a lot about what happened that night. But I feel like we really did get a sense of who he was. And one of the things that stuck out to me was he was almost unnervingly polite. He would say, yes, ma' am and no, ma'. Am. At one point, he actually kind of stopped the interview to ask if I was feeling okay. I actually have a clip of that. I had asked him about his friends, who he shot, and this is what he said. Can you tell me anything about your friends, about Ethan and Ben?

[C]

I'm sorry. All I'm gonna say is that they were very good friends to me. That's all I'm gonna say.

[A]

And you didn't have any disagreements with them?

[C]

No, I never hated them. I never hated him.

[A]

There was no argument?

[C]

No, ma'. Am.

[A]

How do you explain what happened?

[C]

I don't know. I mean, I just need a water break. Just.

[A]

Of course.

[C]

Just a water break.

[B]

Of course.

[C]

I'm sorry.

[A]

It's okay.

[C]

Like, are you okay? Am I not, like, freaking out or anything?

[A]

No, of course not. And it's understandable why you would get emotional.

[C]

I'm just worried about you. Like, are you okay?

[A]

I'm fine.

[B]

He's worried about you.

[A]

Yeah. I'm just worried about you. Like, I don't know about you, Anne Marie, but I've never had someone say that to me in an interview before.

[B]

Absolutely not. Clearly you're asking him a very uncomfortable question, a question that he's struggling to answer. Um, and so I'm, I'm trying to figure out if that response is, you know, kind of authentic interest in what's going on with you or if it is a kind of a stalling tactic. But it reminds me a little bit of him in the police cruiser when he asks like the officer about how his Christmas is going.

[A]

Yeah, are you having a good Christmas? I mean, every time I see that, I gasp. It's just, it's so unusual. And the detective said when they brought him down to the station right after that it was the same sort of thing. This, yes, sir, no, sir, this remarkable politeness. Foreign.

[D]

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[B]

Welcome back. Let's talk about the victims after enter police find 18 year old Ethan Riley and 19 year old Benjamin Bleak. They're lying on the floor. Each of them have gunshot wounds to the head. Both miraculously still alive when first responders arrive at the scene. But Ethan later dies in the hospital. It is Christmas Eve.

[A]

Yeah, I mean the timing of this is just heartbreaking. Connor was released on bond for the first time the same day that Ethan died. So it's hard to fathom what's going on here at Christmas time with these families. You have one family who has their son at home, the son who shot these two boys. And those two boys. Families are in the hospital. I want to talk about Ethan just a little bit. His parents described him as handsome, athletic, bold, good hearted. They said he could carry a conversation with anyone and it was interesting. It struck me that both his father and Ben ended up describing him used the word light. His dad said in court that he was Full of love and light. And Ben, when he was talking about Ethan to me, he said that this is the kind of guy who always looked at things in a positive light, that he was just this outstanding guy.

[B]

And we learn, actually, this is sort of like almost the highlight in the hour is that Ben survives. And the way he's revealed as he sort of walks around the corner, it was shocking and thrilling. And, I mean, if you've got to have, like, something kind of positive to hang onto, there he was.

[A]

Yeah. I mean, walking miracle, right?

[B]

Yeah.

[A]

And just I feel so lucky to be able to sit with Ben and his mom and to see his remarkable recovery and also his sense of humor, as I'm sure you got watching this hour, he has this astonishing sense of humor. A quick story that his mom shared with me. When Ben couldn't talk, she had his friends put together a playlist of his favorite songs, and she would listen to that when she was with Ben. And a song from Toto. You know, I guess it rains down in Africa. Toto comes on, and Shannon, his mom, just bursts out laughing like, this is ridiculous. And she looks over at Ben, and he has a smile on his face, and she just knows, like, my son is back. Like, that sense of humor is intact. You know, he has no memory of what happened that night, but Ben is very crystal clear about why it happened. And he says it has nothing to do with the acne medication.

[B]

In fact, he called it. He called the defense horseshit.

[A]

Yeah. Yeah. Well, that's. Yeah, he doesn't mince words. It's a little bit of his humor, too, there.

[B]

I. You know, I wonder if it's a blessing that she. That he actually can't remember the details of that night. I wonder if it's actually helped him in terms of his recovery. Was Ben close to Connor?

[A]

Ben wasn't super close to Connor, but he was friends with Connor through Ethan, because Ben was super close to Ethan. And Connor's house was kind of the hangout house, so they would hang out as a group at Connor's house. Ben was a little bit older than the other guys. He was already taking college classes. And that's another part of this tragedy, is that he was so independent, you know, really starting his life. And his mom said it was like having a baby again, that she just had to redo everything with him. He had to learn to walk, talk, swallow again. Just starting it all over.

[B]

So, you know, we learn about the defense that's coming, right? This side effect of this very common medication. But then two Weeks before Connor Hilton is set to stand trial, he ends up taking a plea deal. Prosecutors offered him 50 years in prison if he pleaded guilty to murder and aggravated assault with a deadly weapon. Can you talk a little bit about that? Cause when I heard 50 years, I actually thought that didn't seem like much of a negotiation. That's, you know, it's a pretty hefty sentence. I suppose it could have been worse. It could have been life.

[A]

Here's the thing. When we were talking with Connor, the attorneys had gotten. Had just gotten the plea deal. And so as we're. As I was leaving, they went into a conference room to talk about this plea deal. And, yeah, it's a little surprising. In Texas, a defendant gets to choose if they want the jury to sentence them. And the sentence and guidelines for murder are pretty broad. They're between 5 and 99 years for life. So you figure if he rolled the dice and he came off as this polite, sympathetic kid, maybe he could have gotten a lighter sentence. So in this plea deal, he's eligible for parole in 25 years. If he would have rolled the dice and gotten a life sentence, he would have been eligible for parole in 30 years. So it's a difference of five years. So it is kind of surprising that he took the deal. And his parents told us that after sentencing that he called them and said he regretted taking it. But he agreed to this. He signed something saying he understood what he was doing. He waived his right to a trial. He waived his right to an appeal.

[B]

Ben gave a victim impact statement at the plea hearing, and he told Connor that he was never going to forgive him for the grief that he caused his own family and for the Rileys. He came across as very, very strong. But it's clear that this has had quite an impact on Ben. I know you asked him how he was doing, and I want to play some of that sound.

[A]

Through this all, you've managed to show such perseverance. You've been so strong through all of this. What has kept you going?

[C]

I want to get back to where I was.

[A]

What do you mean by that? What do you want to be able to do?

[C]

I know it sounds dumb, but I want to dunk a basketball.

[A]

That doesn't sound dumb. That basketball was so important to you. You want to be able to dunk. You were. You could dunk before.

[C]

Yeah.

[A]

So you want to be able to dunk again.

[B]

You know, Tracy, sometimes we can be distracted by a person's presentation, right? His speech is a little slower. It's a little Tougher for him to move his body. We can see in the hour. But when he speaks. And I obviously never knew Ben until, you know, watching this, but you can almost see who he was before this when he speaks, you know.

[A]

Oh yeah, I so agree. I so agree. And getting out and playing pickleball with him really gave me a chance to see who he was, that strength. I mean, he absolutely kicked my rear end in pickleball. And it's funny like that of all sports for this young guy to be into, but he started it in rehab. They had this group of other people who had suffered spinal injuries, brain injuries, and they would all get together to play and he really took to it. So he's kept. And he and his mom have actually joined a group of older people playing pickleball and they joke that the older people beat them all the time, but my guess is that's not gonna be for long.

[B]

No, definitely not. You know that I have a teenager at home and in watching this hour, it really made me think you have to be on your teenagers all the time. And I certainly have been guilty of, I don't know, everything that my kid looks up online. I'm constantly surprised by her awareness of things in the world and when I ask her where she got it from, she social media or YouTube. But I just hope when parents watch this they realize, like, it is okay to be nosy. You know, get up in that, get up in that computer and see what your kid is looking up and what they are writing on social media.

[A]

That rings for me. I have teenagers too. And that idea that we need to be on them and we need to sometimes be the parent and not the friend and say no has stayed with me.

[B]

Yeah, well, I hope that this is one of the messages that people get when they watch the hours. I'm glad that the victims, families and Ben did not have to go through a trial. But I would have been very interested in hearing the argument and counter argument and whether or not it would hold up as a defense. It's a very unique case. Traci, thank you so much.

[A]

Oh, my pleasure. Thanks for having me.

[B]

If you like this episode, please rate and review on Apple podcasts or Spotify.

[E]

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