Michael Jackson's death highlights celebrity drug abuse problem

After Jackson succumbed to cardiac arrest on Thursday, his family and friends began to suspect that an overdose of strong painkillers and other medications was too much for the singer's frail body and had contributed to the cardiac arrest.

Even as Jackson family patriarch Joe Jackson said the family did not "like what's going on," sources close to the Jackson family, which had hired a private firm to conduct a second autopsy that was completed on Saturday, said the singer's family was "distrustful" of his former business associates, including the doctors, who administered his medicines, and is "determined to find out more."

According to Jackson's former producer and friend Tarak Ben Ammar, the singer was surrounded by "criminals...the doctors who treated him throughout his career, who destroyed his face, who gave him medicine to ease his pain."

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

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New age author and a close friend and adviser of Jackson, Deepak Chopra also suspects that the singer had died due to an overdose of prescription drugs, aided by his doctors.

Chopra said the nanny of Jackson's children had repeatedly contacted him with concerns about Jackson's drug use since his acquittal from a child sex abuse case in 2005.

He said she told him a number of doctors would visit Jackson's homes in Santa Barbara County, Los Angeles, Miami and New York. But whenever the subject came up, Jackson would avoid his calls, Chopra said, adding that the influence of Jackson's doctors over his life was very strong.

"He first denied he had a problem and then admitted he was getting narcotics from several doctors," Chopra said, adding that he recently spoke to Jackson about drug use six months ago.

"Police focus on street drug dealers when more people become addicted to prescription drugs through their doctor. Many expensive Hollywood doctors are just drug dealers with medical degrees," he added.

Chopra said he had first had an inkling Jackson was receiving drugs from multiple sources following his 2005 acquittal on child-sex charges when the star had stayed at his home.

"At one point, he started asking me for a prescription. He knew I was a physician. I had a licence. He asked me for a prescription for a narcotic. And I said 'what the heck do you want a narcotic prescription for?'" Chopra said.

"It suddenly dawned on me that Michael was already taking these and that he had probably a number of doctors who were giving him these prescriptions. That's how he got addicted," he said.

Chopra, a trained cardiologist himself, spoke of a "huge problem" Hollywood had with "celebrity doctors who not only initiate people into the drug experience but then they perpetuate it so that people become dependent on them.

"It's become a culture with celebrity doctors who in one sense get a sense of importance by hanging around with celebrities. I think this is something that really should be investigated because it's a disease. This is a strange addiction. You cannot get these pills or injections unless a physician prescribes them, and (Jackson) had this bunch of enabling doctors who were, in a sense, criminals. And they get away with it half the time - and I hope they don't this time," he said.

Grace Rwaramba, 42, former nanny to Jackson's three children also said there were several occasions when she had to pump the singer's stomach to remove dangerous cocktails of drugs.

"I had to pump his stomach many times," Rwaramba, who was dismissed six months ago, said. "He always mixed so much of it. There was one period that it was so bad that I didn't let the children see him...He always ate too little and mixed too much."

Rwaramba said she had appealed to Jackson's mother, Katherine, and sister, Janet, to persuade him to seek treatment for his addiction, but the singer turned on her and accused her of betrayal.

"He didn't want to listen; that was one of the times he let me go," she said.

According to Jackson family lawyer Brian Oxman, the singer's death raises many questions and he believes that those who were around Jackson during the final moments of his life should be held responsible for his death, as they must have pressurized the singer to perform for the upcoming comeback concert and pushed him towards prescription drugs.

"I don't know the cause of all this. 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. This is something that I feared. This is a case of abuse of medications, unless the cause is something else. This was something which I feared and something which I warned about. Where there is smoke there is fire," Oxman said.

"Over the last several years I have said to family members that he (Jackson) is overmedicated. I have warned of the use of prescription medication and people who have enabled the use of those medications. His family has also been trying for months and months and months to take care of Michael Jackson. (But) The people who have surrounded him have been enabling him," Oxman said, adding that the singer was especially addicted to Demerol, a powerful morphine-based painkiller, whose injection is known to have dangerous side effects including cardiac arrest if used wrongly.

"The family tried many times (to warn him), and I spoke to family members and I said to them 'If this situation arises where Michael perishes because of medications - if we one day wake up and he's dead because of these medications I will not hold my tongue, I will speak out and I will speak out loud," he added.

Though Oxman said he did "not know how much how much (drugs) he (Jackson) has taken" and "what his current situation is in the last couple of weeks," yet, he feels that "they were extensive" and Jackson probably took the medications as old injuries were "getting in the way."

"If you think the case of Anna Nicole Smith was an abuse, that is nothing compared to what has taken place in the life of Michael Jackson," Oxman said, noting that in 2007, Jackson had settled a lawsuit filed by a Beverly Hills pharmacy that claimed he owed more than $100,000 for prescription drugs over a two-year period.

According to David Pruce of the Royal Pharmaceutical Society of London, doctors failed to revive Michael Jackson despite making best attempts because when Jackson died, he was on a lethal cocktail of drugs that included a combination of antidepressants, anxiety pills, painkillers and stimulants.

"The additive side effects - the side effects of the drugs in combination together - could be potentially dangerous if not monitored closely. Painkillers can cause breathing problems and, in high doses, can stop people breathing altogether," Pruce said.

"The other drugs would reduce his responsiveness and make him drowsy and difficult to wake," he said.

According to Karen Sternheimer, a sociologist at the University of Southern California, doctors are as much the victim as the perpetrator of drug abuse.

Doctors can become enchanted by the glamor of the celebrity lifestyle and may find it hard to refuse potent painkillers for their clients because of their wealth and power, Sternheimer said.

"It's a big issue with people who are used to getting what they want. And if someone says no, they can pay someone else to get what they want," she said.

"The physician is not immune to that heady feeling of being in a celebrity's inner circle," she added.

In other instances, the doctors themselves may have questionable pasts or significant debts, and caring for a celebrity allows them to make large amounts of money, said Julie Albright, a sociologist at the University of Southern California.

"Some of these people might not be the most successful doctors, so the money will also buy their complicity in fueling a drug habit," said Albright, who was speaking generally and not specifically about Dr. Murray.

"Megastars may be given more leeway than ordinary patients because of their wealth," and because of expectations that the famous often have eccentric habits, Albright said.

"It's almost expected in some ways if it's a rock star or a big actor. You almost expect them to have a larger-than-life lifestyle," she said. "People are drawn to celebrity like a moth to a flame, including these doctors who want to be around that lightness and brightness."

Agrees Battle Against Tranquillisers (Bat) spokeswoman Una Corbett. "Painkiller abuse normally starts as pure pleasure and it grows into an addiction as people discover it helps block out things that they don't want to think about," Corbett said.

Marilyn Monroe died at 36 from an overdose of sleeping pills in August 1962. She had been under a doctor's care at the time.

Elvis Presley, who died in 1977 at 42, was known to travel with George Nichopoulos, a former physician who overprescribed drugs to clients. Nichopoulos lost his medical license but was acquitted of criminal charges related to Elvis' death.

More recently, Los Angeles County prosecutors charged a psychiatrist and a doctor with conspiring to provide Anna Nicole Smith with thousands of prescription pills.

Smith died February 8, 2007, in Florida after collapsing at a hotel; medical authorities later ruled her death an overdose.

In January 22, 2008, Heath Ledger died from an accidental overdose from the combined effects of ingesting oxycodone, hydrocodone, diazepam, temazepam, alprazolam and doxylamine.

Michael Jackson's personal cardiologist, Dr. Conrad Murray, was hired by the singer earlier this month to accompany Jackson on his planned summer concert tour, despite having a tangled financial and personal history himself.

Records reveal years of financial troubles for Dr. Murray, a 1989 graduate of Meharry Medical College in Nashville who practices medicine in California, Nevada and Texas.

Over the past 18 months, Murray's Nevada medical practice, Global Cardiovascular Associates, has been slapped with more than $400,000 in court judgments: $228,000 to Citicorp Vendor Finance Inc., $71,000 to an education loan company and $135,000 to a leasing company. He faces at least two other pending cases.

Court records also show that Dr. Murray was hit last December with a nearly $3700 judgment for failure to pay child support in San Diego, and had his wages garnished the same month for almost $1500 by a credit card company. Another credit card claim for more than $1100 filed in April remains open.

He also owes $940 in fines and penalties for driving with an expired license plate and for not having proof of insurance in 2000.