Drug mix Michael Jackson took is key

Copyright 2009 Times Newspapers Ltd.

http://entertainment.timesonline.co.uk/tol/arts_and_entertainment/music/article6585279.ece

 

Dr Martyn Lobley

The list of prescription drugs that Michael Jackson was reported to have taken includes drugs from three main chemical classes. Those most frequently referred to are the anti-depressant sertraline, known as Zoloft in the US and Lustral in Britain, the Valium-like tranquilliser alprazolam (Xanax) and the morphine-like painkiller pethidine (Demerol).

It is reported that Jackson collapsed shortly after an injection of Demerol, presumably administered by a doctor or nurse. The timescale is not clear, but the limited interval between the injection and his collapse suggests that the two may have been linked.

All tranquillisers and morphine-like painkillers are known to affect patients breathing patterns, especially if taken in excessive doses. Doctors know that the large single doses of opiates and sedatives given to patients in their final hours to relieve pain could shorten their lives by depressing their respiratory efforts.

When two drugs are given together, especially if they are from different classes, the effects do not simply combine they multiply. Doctors make use of this when treating high blood pressure where low doses of two drugs given simultaneously are often more effective than high doses of one or the other. But the multiplication principle also holds true for unwanted effects. The death of the actor Heath Ledger last year was attributed to the combination of Xanax with another opiate painkiller, oxycodone.

Related Links

• Police question doctor over Jackson's treatment

• The recorded call that signalled last moments

The sedative effect of previous doses of Xanax, combined with an injection of Demerol, could have been responsible for the apparent shallowness of Jacksons breathing in the minutes that followed. By the time that the 911 call had been logged by the emergency services his breathing had stopped altogether. The sedation resulting from the drug combination may well have removed the desire for him to breathe for himself as surely as if the drugs had been administered by an anaesthetist.

When breathing stops and the heart is deprived of the oxygen required to function a cardiac arrest is inevitable.

As soon as a patient collapses the priority is to re-establish some sort of circulation and to provide essential oxygen, usually by administering cardiopulmonary resuscitation (CPR). If the cause of collapse is known it is mandatory to deal with that too. A collapse as a result of a heart attack is often due to a pulse abnormality known as V-fib (ventricular fibrillation) and a couple of shocks from a defibrillator may restore the hearts normal rhythm.

If the reports are accurate, the short time between the injection and the collapse would mean that the doctor who injected the Demerol would probably have considered administering an opiate antagonist (or antidote) to reverse any respiratory depression.

The effects of the most commonly used antidote, naloxone, are short-acting but the time it buys the emergency response team, allowing them artificially to ventilate a patient, is invaluable.

But even in the best situations, attempts at CPR are not always successful. Jackson was known to be physically frail, reportedly weighing as little as 7st, and to be under great stress. Perhaps it is not surprising that the paramedics and emergency room staff were unable to revive him.

Dr Lobley is a general practitioner in South London

http://www.associatedcontent.com/article/1881770/demerol_may_have_played_role_in_michael_pg2.html?cat=33

Icon Possibly on Seven Medications at Time of Death

Demerol is a very strong narcotic. Years ago, in response to terrible pain, my doctor gave me Demerol in the emergency room. Demerol must be monitored on its own let alone with other medications. Demerol also may have played a role in the death of Michael Jackson.

The Life and Style section on Kansas City.com has posted an article titled "Report: Overdose of prescription drugs may have killed Michael Jackson" that indicates Michael Jackson was apparently taking a number of prescription drugs including Demerol and numbering up to

 seven.

It was further reported that Jackson had been taking Xanax, Zoloft along with the Demerol during the last few months.

This information was reported by an "insider" close to Jackson who went on to surmise that his death was an overdose of prescription drugs.

In a previous article I wrote that the family lawyer Brian Oxman said that Jackson was being pushed unduly in preparation for his upcoming London by "unnamed enablers."

Oxman compared Jackson to Anna Nicole Smith so it is difficult to surmise whether or not he meant enablers as in "people" or enablers as in "drugs."

It is known that he was pushing very hard for his comeback and was working with Lou Ferrigno to get his physical edge back.

Anyone familiar with Jackson's work knows he was an incredible dancer and used a lot of energy in a show. At 50-years-old he would have to be in top shape.

Michael Jackson has an extensive history of medical problems. I have linked to them because there are too many to list in this article.

In reviewing what happened to Jackson he apparently, as it stands now, had a cardiac arrest from prescription drugs.

As I have written in several other articles there is a problem with mixing serious drugs like Demerol with other drugs.

When a mixture works one day there is no guarantee that it is going to work the next day. Therefore you take a new chance everyday.

What is incredible is that Jackson had a doctor visit him every day and still the medications got to him.

Michael Jackson is an icon, a word that is thrown around too easily these days.

Sadly, being an icon doesn't protect you from your own humanity.

References:

 

Icon Possibly on Seven Medications at Time of Death

http://www.cnn.com/2009/HEALTH/06/25/michael.jackson.heart.health/index.html

http://www.kansascity.com/stargazing/story/1282600.html

http://pakalert.wordpress.com/2009/06/27/like-elvis-michael-jackson-died-of-serotonergic-medications/

 

As suspected, and now confirmed, Michael Jackson dead at age 50 do to Serotonin Syndrome as a result of 2 serotonergic medications Zoloft (antidepressant) and Demerol (pain killer).

Lisa Maire Presley has not only lost her father, but now also her Ex-husband, to the same basic combination of drugs: antidepressants and pain killers.

Michael Jackson lost his life due to the organ-stopping effect of Serotonin Syndrome thanks to a drug that should have been removed from the market decades ago Demerol. A serotonergic medication similar in action to antidepressants, atypical antipsychotics, and other pain killers.

Serotonin constricts smooth muscle tissue. The major organs of the body are composed of smooth muscle tissue. When serotonin levels increase too high the major organs constrict and shut down. Elevated serotonin, which all of these medications produce, causes death via multiple organ failure. This is the same way Daniel Smith, Anna Nicole Smiths young son lost his life due to the combination of four serotonergic medications.

Are Drugs To Blame For Jacksons Death?

http://www.kansascity.com/stargazing/story/1282600.html

The star had been taking prescription painkillers including anti-anxiety drugs Xanax, Zoloft and painkiller Demerol in recent months, sources close to Jackson told Life & Style

Life & Style reports that Michael Jackson was taking a cocktail of up to seven prescription drugs in the months before his death.

The star had been taking prescription painkillers including anti-anxiety drugs Xanax, Zoloft and painkiller Demerol in recent months, sources close to Jackson told Life & Style. The insider close to the star said he took a suspected overdose of drugs on Thursday morning, which caused respiratory and cardiac arrest.

And a Jackson family lawyer told CNN he feared the drugs could kill the pop star.

 

Jackson family lawyer Brian Oxman confirmed Jackson may have had trouble with prescription drugs as he prepared for his London show.

This was something which I feared and something which I warned about, Oxman said on CNN. I can tell you for sure that this is something I warned about. Where there is smoke there is fire.

Mr Oxman compared Michael to Anna Nicole Smith, allegi ng that Michael had enablers just like her.

CNN details Jacksons long history of medical problems here. At a news conference, brother Jermaine Jackson said doctors and family tried for an hour to resuscitate the performer. TMZs video of the conference is here.

Meanwhile, Hollyscoop reports that doctors visited Jackson daily. The sites latest update:

While news of Michael Jacksons death came as a shock to many, inside sources tell Hollyscoop exclusively that the King of Pop had doctors visiting him daily.

Michael went into cardiac arrest Thursday afternoon and was rushed to UCLA Medical Center around 1pm. His personal physician was with him at the time and accompanied him to the hospital.

At approximately 1:14pm when he arrived at the hospital, doctors and emergency personnel performed CPR and tried to resuscitate him, but were unsuccessful. He was pronounced dead at 2:26pm.

The cause of his death is still unknown, but an autopsy is scheduled for this coming Friday afternoon. Michael was transferred from UCLA Medical Center to the coroners office via a Los Angeles Sheriffs helicopter shortly after 6pm.
Posted on Thu, Jun. 25, 2009 08:41 PM

http://www.kansascity.com/stargazing/story/1282600.html

The Sun UK
6-26-9

As the world continues to try to grasp and make sense of the incredibly shocking death of Michael Jackson, several people close to the family and investigation are hinting that prescription drugs may have played a role in the King of Pops demise.

TMZ is reporting that a Jackson family members have confirmed that Michael received a shot of Demerol just before Noon on Thursday, and that the dosage was too much. They say Jackson typically received a shot of Demerol daily.

Britains The Sun, citing sources at the UCLA hospital where Jackson was treated, is reporting that Jackson stopped breathing shortly after a shot of Demerol, a drug similar to morphine. Shortly after taking the Demerol he started to experience slow shallow breathing. His breathing gradually got slower and slower until it stopped, the Sun source said.

________

Dr. Ann Blake Tracy, Executive Director,
International Coalition for Drug Awareness
www.drugawareness.org & author of Prozac: Panacea
or Pandora? Our Serotonin Nightmare & audio Help!
I Cant Get Off My Antidepressant! (800-280-0730)

A senior law enforcement official told ABC News that Jackson was ''heavily addicted'' to the painkiller Oxycontin and was injected daily with that medication, along with Demerol.

http://www.mb.com.ph/node/204555

Jackson items up for sale

June 27, 2009, 8:34pm

LAS VEGAS (AP) A collection of Michael Jackson memorabilia is up for auction in Las Vegas - a potentially lucrative coincidence a day after the singer's death.

A celebrity auction Friday at the Planet Hollywood Resort and Casino has been planned for months, and was promoted mostly as featuring Elvis Presley and Marilyn Monroe items.

Speaking to a throng of reporters outside the coroner's office, Los Angeles County Coroner's spokesman
Craig Harvey said, ''There was no indication of any external trauma or indication of foul play to the body of Mr. Jackson.''

Police said they were seeking to question Jackson's personal physician, identified by news media as Houston-based cardiologist Dr. Conrad Murray.

Jackson's body was moved to a mortuary at the family's request on Friday night, assistant chief coroner Ed Winter told reporters. He did not disclose the location and there was no immediate word on when Jackson would be laid to rest.

Celebrity website TMZ.com, citing an interview with an unidentified ''close member'' of the Jackson family, reported the entertainer was injected with Demerol about half an hour before he went into cardiac arrest.

TMZ, citing family members, said Jackson received a daily shot of Demerol, a narcotic painkiller, and that the family believed his death was caused by an overdose of the drug.

Detectives searched Jackson's home and impounded Murray's Mercedes from the driveway, saying it might contain evidence.

An unidentified man called a 911 emergency phone line from the mansion at 12:21 p.m. local time, saying Jackson was unconscious and not breathing.

In excerpts from the call released by authorities, the caller said the physician was the only other person present and was frantically performing cardiopulmonary resuscitation on the unconscious Jackson without results.

''He's pumping, he's pumping his chest but he's not responding to anything, sir, please,'' the man said.

A senior law enforcement official told ABC News that Jackson was ''heavily addicted'' to the painkiller Oxycontin and was injected daily with that medication, along with Demerol.

Lawyer Brian Oxman, a Jackson family spokesman, told CBS' ''The Early Show'' he had been concerned about the prescription drugs Jackson took due to injuries suffered while performing.

''I do not want to point fingers at anyone because I want to hear what the toxicology report says and the coroner says but the plain fact of the matter is that Michael Jackson had prescription drugs at his disposal at all times,'' Oxman said.

Fans and fellow pop stars revived memories of Jackson's musical genius, tarnished over the past decade by accusations of child molestation and eccentric behavior.

US President Barack Obama called Jackson a ''spectacular performer'' but said he believed aspects of his life were ''sad and tragic,'' the White House said.

Jackson's death was front-page news around the world as airwaves filled with his greatest hits from ''Thriller'' to ''Billie Jean'' and social networking sites were bombarded with messages and tributes.

''My heart, my mind are broken,'' actress Elizabeth Taylor, long a close friend of Jackson, said in a statement.

''He will be in my heart forever but it's not enough,'' Taylor said. ''My life feels so empty. I don't think anyone knew how much we loved each other.''

On Hollywood Boulevard, police put up barricades to control thousands of fans who filed past Jackson's star on the Walk of Fame to honor the child prodigy who became one of the top singers of all time with an estimated 750 million albums sold.

About 50 people danced to such Jackson hits as ''Rock with You'' and ''Beat It'' in New York's Washington Square. When ''Thriller'' played, the crowd formed into lines to imitate the moves from Jackson's ground-breaking video for the song.

Facing a battered reputation and a mountain of debt that The Wall Street Journal reported ran to $500 million, Jackson spent the last two months rehearsing for a series of London concerts, including Wednesday in Los Angeles."

Warnings & Precautions (page 4) of OxyContin rxlist

http://www.rxlist.com/oxycontin-drug.htm

"...Respiratory Depression

Respiratory depression is the chief hazard from oxycodone, the active ingredient in OxyContin® , as with all opioid agonists. Respiratory depression is a particular problem in elderly or debilitated patients, usually following large initial doses in non-tolerant patients, or when opioids are given in conjunction with other agents that depress respiration..."

 

Side Effects (Page 3) re respiratory depression and respiratory ARREST

"Serious adverse reactions which may be associated with OxyContin Tablet therapy in clinical use are those observed with other opioid analgesics, including respiratory depression, apnea, respiratory arrest, and (to an even lesser degree) circulatory depression, hypotension, or shock (see OVERDOSAGE)..."

They certainly don't appear to have had Michael's well-being at the top of their list of prescribing priorities.  Those two drugs alone could have caused his respiratory and cardiac arrest, with or without any SSRIs.

http://www.theaustralian.news.com.au/story/0,25197,25696326-26397,00.html

Michael Jackson's weakness 'exploited by charlatan doctors'

Brad Norington | June 27, 2009

MICHAEL Jackson died "because he was taking all sorts of medicines" prescribed by "charlatan" doctors who exploited his hypochondria, the pop star's friend and former producer Tarak Ben Ammar said last night.

"It's clear that the criminals in this affair are the doctors who treated him throughout his career, who destroyed his face, who gave him medicine to ease his pain," the Tunisian producer told France's Europe 1 radio.

"He was a hypochondriac and one never really knew if he was sick because he had become surrounded by charlatan doctors who were billing him for thousands and thousands of dollars worth of drugs, vitamins."

He said Jackson regularly took sleeping pills, adding he had never seen him take illegal drugs. "He ate badly, he didn't have a very healthy life, he couldn't do sport," he said.

Doubts had already emerged about whether Jackson's health would stand up to 50 concerts at London's O2 arena from next month. Despite friends urging him to pull back, he was reportedly training and rehearsing six hours a day near his rented $US100,000-a-month mansion in the Los Angeles suburb of Bel Air, where he collapsed.

"He wanted to rehearse more, but the medications were getting in the way," said Brian Oxman, a friend and former Jackson family lawyer who was with two of the reclusive star's brothers at the UCLA Medical Centre, where he was confirmed dead. Mr Oxman said he had warned the family that if Jackson "wound up dead", he would protest about abuse of prescription drugs.

Jackson was widely reported to have been addicted to painkillers. "We feared that this kind of thing would happen, and here we are," Mr Oxman said.

Mr Oxman declined to go into the specifics of the medications taken by Jackson, and said he would await the results of toxicology results after today's autopsy.

"I won't jump to conclusions, I won't point fingers," he said on MSNBC television. "But when the results of this testing is going to be completed, I intend to be very loud and vocal, depending on the outcome of those tests."

While preliminary results of the autopsy could be released today, toxicology results are expected to take longer.

Tom Potts, an Access Hollywood reporter, claimed Jackson had been fed "illegal prescriptions in massive quantities" brought into the US from Mexico. Potts said some supporters had wanted to "screen out" these drugs as a way to help the singer.

The Los Angeles Police Department is investigating Jackson's death, but a spokesman indicated it was normal because of his celebrity. "Don't read into anything," he said...."