“What Killed Michael Jackson?”

Posted by drgracesun on June 27, 2009 under Current News Events, Information | Be the First to Comment

We were all stunned and saddened with the passing of Michael Jackson – it’s natural that we have a hard time accepting the early lost of such a talented person. Why did Michael past away in such sad and unexpected circumstances? Questions surrounding his prescription medications are being raised and the toxicology report might take up to eight weeks to reveal the facts. It is times like these that remind us to be cautions about using prescription drugs, especially potent painkillers, which should be discussed and brought to the public’s attention, to lower the risk of potential abuses.

Suffering from intense physical pain is one of the most unpleasant life experiences a person can go through. Modern medicine allows us to manage pain with over-the counter and prescription medications. When the pain level is intense and acute, prescription drugs will “take the edge off” of pain, and risks of adverse effects is low. On the other hand, when the physical pain becomes chronic, or repetitive, pain management with prescription drugs can become a very difficult task to sustain one’s physical and mental health and facing high risk of abuses. In America, problems of abusing prescription drugs can often times be bigger than street drugs.

The two narcotic analgesics (pain medications) mentioned in the media which were prescribed to manage Michael’s physical pain were Oxycontin and Demerol (from when he had suffered burns and over the years never stopped using prescription pain meds). Both of these drugs are opioid agonists which include such pharmacological effects as anxiolysis, euphoria, feelings of relaxation, respiratory depression, constipation, cough suppression and analgesia with abuse liability similar to morphine. When the 911 call happened, the description of ” not breathing”, which was respiratory arrest, could have been a consequence of the adverse effects of opioid agonists. There should not be any speculation as to what really happened to Michael as the toxicology report will not be ready for many weeks – he was under the care of a private physician, although an experienced cardiovascular nurse could have been an important person on staff for better patient monitoring and care.

The PDR (Physician’s Desk Reference) states that Oxycontin tablets are to be swallowed whole and not to be broken, chewed, or crushed (which can lead to the rapid release and absorption of a potentially fatal dose of oxycodone). When Demerol is intravenously administered, overdose can lead to circulatory collapse, cardiac arrest or death.

We need to be sympathetic with one’s suffering and pain – everyone should have an individualized pain management program depending upon certain physical and mental conditions, physical activity, diet and other habits. As for any health care provider, one needs to think about the long term health and well being of a patient, which at times might mean saying “no” to excessive requests for potent narcotics. Seeking solutions to correct the root of the problem and prevention should be at the forefront of any physician’s agenda. Initiating therapy at the appropriate point along the progression from non-opioid analgesics, like anti- inflammatory drugs (such as Ibuprofen) and acetaminophen (Tylenol) to opioid in pain management must be considered.

Michael, we all miss you! Strenuous 8-hour day rehearsals for shows set to open in London, combined different medications for treating chronic pain combined with ongoing mental stress proved a fatal combination for a true genius of our time.