Tag Archives: Ativan

Deaths of Rock Stars – Learning From Their Mistakes

With the sad untimely death of Amy Winehouse, questions are yet again being asked why rock stars have a penchant to be associated with a death wish in conjunction with drugs. She joins a long line of celebrities.. Jimi Hendrix, Janis Joplin, Jim Morrison(the Doors), Ron McKernan (the Grateful Dead) who all died due to drugs at the age of 27 strangely enough (the 27 Club). Add to this Michael Jackson, of course.

Could drugs be the cause of death for Amy Winehouse?

Maybe its easier to understand why these celebrities take to drugs..as an escape from stress, as performance enhancers to keep up to fans’ expectations and also to enforce sleep when the mind doesn’t want to switch off.

Quite often these drugs gradually lose their effect once taken over long periods, thus necessitating higher and higher doses, which can lead to overdosage. But yet, this does not seem to be the case in some  instances.

Propofol, a common anaesthetic used in hospitals, gained notoriety when it was blamed for MJ's death

On the other hand, there are cases where there has been untoward drug interactions when many prescription drugs with similar actions are taken concurrently. In other words, therapeutic doses of several prescription drugs, usually pain-killers and sleeping pills, had been taken at about the same time, creating a deadly mixture due to chemical interaction. Such was the case with Michael Jackson, where propofol, lorazepam (Ativan), midazolam (Dormicum) and diazepam (Valium) were found at autopsy amongst others.

Here are what I see are some of the  mistakes that occurred and the measures that can be taken:

  • 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.
  • 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.
  • Alcohol does not jive with many medications – together with sleeping pills and cold medications, even some antibiotics (eg Bactrim, Flagyl) can cause unpleasant reactions.
  • 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.

MJ’s Death Explained


MJ - before and after cosmetic surgery

The Los Angeles County coroner has ruled Michael Jackson’s death a homicide, a law enforcement official told The Associated Press and MSNBC. The term homicide is rather confusing, especially to countries in the British Commonwealth. Briefly, homicide means  to take the life of someone or to kill a person, but does not necessarily mean a crime was committed.

Although this term is used widely in the US, it had its origin in ancient British law. There are several types of homicide which include non-criminal causes like self-defense, insanity or when a criminal is hanged by order of the court (capital punishment). In the case of MJ’s doctor, it was reported that he was to be charged with a type of homicide called manslaughter, which is criminal in intent but just falling short of murder.

I had highlighted in an earlier post soon after MJ’s death (“What Killed Michael Jackson?”) that a likely cause of his death would be a cocktail of sleeping pills, each given in the correct dose one after another when the desired sleep effect did not occur. This has been confirmed by the coroner’s report, which mentioned that he was first given a 10 milligram tablet of diazepam (Valium) at 1.30am, then an intravenous injection of 2 milligrams of lorazepam(Ativan) at 2am followed by 2 milligrams of midazolam (Dormicum) around 3 a.m., and repeats of each at 5 a.m. and 7:30 a.m. respectively.

Even this did not put MJ to sleep.


Propofol -used commonly by anaesthetists to induce sleep.

The doctor told detectives that around 10:40 a.m. he gave in to Jackson’s “repeated demands/requests” for propofol, which the singer referred to as his “milk” but often referred to by doctors as the ” milk of amnesia“. He administered 25 milligrams of the white-colored liquid, — a relatively small dose — and finally, Jackson fell asleep. He left MJ for a few minutes but returned to find that he “had stopped breathing”.

The above facts lend credence, in my opinion, that the various cocktails of drugs, although each given in the proper doses, had caused additive effects leading to the breathing centre of the brain to stop functioning (these drugs are known to cause this) and consequently depriving the heart of the much-needed oxygen causing the heart to also stop functioning. “This is polypharmacy at its worse”, said a source familiar with the case.

Some of the lessons we need to learn here are that sleeping pills, if it has to be used, should be on short-term only and must not be mixed, not even with alcohol. It is common to find that those on long-term pills will eventually get addicted to them and require progressively higher doses to get the required effect.

See my other article Death of the Stars…Learning from Their Mistakes” to pick up other tips.

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