In December 2023, Connor Hilton, then 17, shot his friends Ethan Riley and Benjamin Bliek in the head inside his home in Friendswood, Texas, ultimately killing one.
When police arrived on the scene, Hilton was visibly distraught. In interrogation footage seen in a new report from CBS News’ “48 Hours,” he cried and told police, “What I did was wrong. I need to do the punishment. I know that. But I also need help. I need really, really — I need some help.”
Hilton admitted to feeling suicidal and homicidal — he and his family claim a popular prescription drug for acne was to blame for the uncharacteristically violent act.
Immediately after the shooting, Hilton told police that he’d been in an argument with his friends and fired in self-defense. But in other moments — including in an interview at the station — he told a different story.
“I need to be put in a mental hospital,” he was heard saying on bodycam.
“I’ve had suicidal, homicidal thoughts for so long,” he told officers. “What I did was wrong. I need to do the punishment. I know that. But I also need help. I need really, really — I need some help.”
His defense team claims the culprit was Accutane. The retinoid medication is prescribed to treat severe acne and can resolve deep, painful cysts and nodules when other options don’t work.
Though the brand-name drug Accutane is no longer distributed in the US, its active ingredient — isotretinoin — continues to be available generically.
While it’s effective for fighting acne, it also has some pretty severe risks, warranting a “black box” warning for depression, suicidal thoughts, hallucinations, aggressive and/or violent behaviors and even psychosis.
Researchers believe this is due to how certain chemicals in the brain that affect mood, like dopamine and serotonin, are altered.
In one 2014 case study, a 27-year-old man who’d been taking the drug for two weeks developed acute psychosis and was convinced his colleagues were trying to kill him, his phone was hacked and his computer was being monitored. He returned to normal after discontinuing the medication.
According to police transcripts, Hilton confessed he’d been experiencing suicidal and homicidal thoughts, convincing his mother to buy the gun for him so he “could either shoot myself or shoot somebody.”
The day before the shooting, he reportedly missed his daily dose of the medication. So the day of the shooting, he took double.
“There’s a large number of people throughout the world that have experienced side effects from [isotretinoin] … including psychiatric side effects,” Doug Bremner, a professor of psychiatry and radiology at Emory University School of Medicine, explained in an interview with CBS.
“I think he became psychotic on Accutane, and he had recurrent homicidal ideation that he was not able to control.
“These… thoughts did not occur before he took Accutane,” added Bremner. “He went off the drug, and those thoughts went away. And then he started the drug again, and the thoughts came back. So that’s considered to be proof basically of a causal effect between a drug and a symptom.”
Hilton’s defense team had planned on using the acne drug symptoms as a defense for the teenager’s violent actions, similar to a 2018 Colorado case.
“Basically, our expert [Bremner] said that because of using Accutane, he was in psychosis and could not control his conduct — it’s consistent with what happened in this case,” one of Hilton’s lawyers, Rick DeToto, said at the time. “That he was a normal kid until he started using Accutane.”
However, the judge ruled that the information was inadmissible for determining guilt, and Bremner could not testify on Hilton’s behalf.
Hilton pleaded guilty to murder and aggravated assault and was sentenced to 50 years in September of 2025.
Last week, Matthew and Tara Riley — parents of Ethan Riley, who was killed — were awarded $60 million in a civil suit that determined that Hilton’s mother, Johnece Hilton, was grossly negligent in failing to keep her son away from the handgun she purchased.
If you are struggling with suicidal thoughts or are experiencing a mental health crisis and live in New York City, you can call 1-888-NYC-WELL for free and confidential crisis counseling. If you live outside the five boroughs, you can dial the 24/7 National Suicide Prevention hotline at 988 or go to SuicidePreventionLifeline.org.
