Death of The Stars..Learning From Their Mistakes


In my previous posting, I alluded to the possibility that Michael Jackson’s death could be due to the potentiating effects of several opiate prescription drugs like oxyContin & pethidine. We will know for sure whether this is the case, in a few weeks when the toxicology results are announced.

heathledger2In the case of Heath Ledger, who died at 42, the coroner found six different tranquillisers & opiate pain-killers in his tissues and concluded that accidental overdose was the cause of death. The prescription drugs found included OxyContin, hydrocodone, diazepam (Valium), temazepam (Normison, for sleep), alprezolam (Xanax,for anti-anxiety) and doxylamine (available over-the-counter as Somnil for aiding sleep).

annanicolesmithAnother case in point is that of Anna Nicole Smith, who died aged 39 in early 2007 due to massive doses of a sedative chloral hydrate together with at least 9 other tranquillizers that included Valium, Ativan and Rivotril.

The common denominator in all the three above cases (assuming MJ’s results are confirmed) is that there has been untoward drug interactions where many prescription drugs with similar actions are taken concurrently. The thing to note is that there need not  necessarily be a overdosage of any particular drug – sometimes normal dosages, when taken at the same time, create a cascading effect and  cause these untoward effects aka drug interactions aka drug toxicity.

Here are some common mistakes that can be avoided:

  1. Usage of several painkillers in an attempt to get fast relief –  people with long-term pain like backache may resort to increasingly stronger medications as the body gets used  to them. In MJ’s case, it has been reported that he had been on oxyContin (an addicting painkiller derived from narcotics) for many years and had received pethidine (another narcotic painkiller) at the same time. The false and wrong rationale is usually that the more one takes, the better for fast pain relief.
  2. Taking a cocktail of sleeping pills to ‘knock off’ – expecting a sleeping pill to work immediately can lead some people to erroneously take ‘more of the same or similar’ in an attempt to induce sleep quickly and perhaps get rid of unpleasant memories of the day. This is compounded when alcohol had been taken as it is a brain “downer”, just like sleeping pills. The combined effects of these pills and alcohol will suppress the brain from allowing the lungs to breathe. Never mix sleeping pills, sedatives, tranquillizers or take them with alcohol.
  3. Alcohol does not jive with many medications – apart from sleeping pills and cold medications, even some antibiotics (eg Bactrim, Flagyl) can cause unpleasant reactions.
  4. Using many doctors or pharmacies – when visiting multiple doctors, bring along the list of medications in your possession so that there is no inadvertent cross-reactions. Similarly, using only one pharmacy enables screening with existing medications to prevent harmful drug interactions.

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One response

  1. Dear Doc,

    One of the things that I truly enjoyed reading your write up, is the no frill kind of writing that pieces together a few puzzles to see the bigger picture.

    Just like I watched air crash investigation,or CSI (fiction) it is not normally a single factor or anything like it that leads us to something, or at least trigger a chain of events.
    This serves as really good reminder that, to not simply pop those pills like when we took “smarties” when we were kids.
    Have a nice weekend.

    Doctor2008 says : Quite right..medical errors are not the fault of one person, but the fault of the system within which he/she operates! All the docs who prescribed those pain-killers did it perhaps for their selfish reasons, but also because the system allowed them to do so.

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