Author: admin Posted in: Uncategorized
The dust is just beginning to settle around Michael Jackson’s coffin — he’s not yet in the ground. His family is still waiting for the results of the second autopsy.
Rumors, half-truths, lies, and disguised truths seem to swirl around him like flies around manure. In the process of managing his public/private persona Mr. Jackson has created a lot of false impressions and a lot of rumors. Sorting the truth out of this is almost impossible.
Rumors about the causes or potential causes of his death are almost as numerous as the people reporting his death. I consider his death a great tragedy! This is mainly because he didn’t need to die!
At the time of his death, attendants, responding to his every wish, surrounded him. He even had a physician serving him full time. I’ve heard reports of other celebrities doing the same kinds of things. All of these retainers and attendants cost a lot of money. He certainly had access to the money.
Unofficial reports indicate that he had at least 10 different physicians serving him at various times, and a lot of them treated him for back pain.
Reportedly, he injured his back in the fall at a rehearsal. Not wanting to interrupt his practice and performance schedule, he chose to take medicines rather than getting effective and wise treatment for his injury and pain.
The doctors who were treating him either lacked the knowledge or the determination to really figure out what his back problems were, or to treat them effectively and properly.
While investigators carried off large bags of drugs and prescription medication containers from his house after his death, we are left only with allegations and speculations about what he was taking and for what.
I am assuming that there is at least a substantial degree of truth in the reports about what medicines he was taking. The people who know precisely what he was taking aren’t talking; and those who are talking don’t know.
The rumors about his medications include a long list of medicines. These include: Vicodin, a narcotic; OxyContin, a narcotic; Demerol, another narcotic; Soma, a sedative which is metabolized to meprobamate, another sedative; Xanax, a sedative benzodiazepine, commonly used to suppress anxiety. Also on the list are Zoloft and Paxil. These two drugs are antidepressants.
If the reports about these medicines are true, they are evidence of careless prescribing by physicians who really weren’t paying attention to what else he was taking, and were somewhat ignorant of the interactions between the drugs, and the potential complications.
Using OxyContin and Vicodin together is not necessarily bad practice, and in fact may be good. Use of narcotics in this way can sometimes be effective in controlling pain in someone who has chronic pain that cannot be controlled without them. I suspect Mr. Jackson simply wanted to get his pain relieved and get on with his music. I don’t blame him for this particularly. But, this motivation combined with his very large amounts of money, would push the physicians into careless practice. This still does not excuse them.
Using Zoloft and Paxil together, simply doesn’t make sense. Their effects are the same, and increasing the dose of one rather than adding a separate drug with the same effect can achieve the same effect.
People who drive themselves hard frequently use a lot of caffeine to keep themselves going. Because of the caffeine they frequently have difficulty sleeping. The best way to deal with that is to increase exercise and decrease caffeine. I don’t know whether Mr. Jackson was using a lot of caffeine. But, it’s common in people who are using narcotics to relieve pain.
The Xanax really is in a class by itself and has its own particular set of effects. It is anticonvulsant, sedative, and somewhat anti-anxiety.
The Demerol he supposedly was getting, is a problem by itself. Physicians experienced in the treatment of chronic pain rarely prescribe it. The reason is simple. It relieves pain quite effectively, but is metabolized to normeperidine, which tends to slowly accumulate in the body, and causes convulsions. Prior to full-blown convulsions, patients on Demerol usually exhibit increased anxiety and muscle twitching. Xanax will suppress the muscle twitching and anxiety. This allows the normeperidine to accumulate high levels in the body. Then it can cause disturbances of the heart rhythm.
This problem with the metabolite of Demerol is the reason experienced pain physicians almost never prescribe it. It just causes too many problems.
It appears that his physicians were very unwise in the way they attempted to treat his pain. They didn’t seem to understand that pain is not a drug deficiency.
I am saddened by Mr. Jackson’s untimely death; and by the grief his family is suffering. My heart goes out to them. Perhaps he and other entertainers can serve as lessons for all of us. In that way even his death may not be wasted.
He needed to take better care of himself. We also need to be careful to take good care of ourselves.
How do I know about these drugs and problems? Simple, I’m a retired physician pain specialist.
Live well!
Ken Noel, MD