• Joey Baldwin, of Santa Fe, Texas, killed himself and blamed “bath salts” in his suicide note. The 31-year-old became paranoid, began hallucinating and eventually committed suicide. He was discovered by his father (Craig, 2011).

• Ryan Foley, a 25-year-old white male, high on bath salts, broke into St. Ann’s Monastery in Scranton, Pennsylvania, with a wooden mallet and knife, and attacked a priest, cutting his face and his hand. Foley had snorted bath salts “approximately four times” that evening (Hughes, 2011).

Amy Winehouse has died. The 27-year-old soul-jazz diva, after a long, public battle with drug addiction, failed interventions and numerous health concerns, was found lifeless in her Southgate home on July 23, 2011. London Ambulance Services said that the soulful singer died before the two ambulance crews arrived (Lawless, 2011). She was pronounced dead at the scene and police labeled the cause of her death as “unexplained but not suspicious,” meaning drugs and alcohol were the suspected cause.

There is nothing neither explicable nor understandable about the tragic saga of English R&B singer Amy Jade Winehouse. Amy Winehouse remains an enigma, a contradiction. Her mission of self-destruction, an example of society’s “celebrity blood voyeurism,” our lust for the expected crash, overdose or self-inflicted gunshot, also paradoxically demonstrates our powerlessness over such behaviors.

The common denominator connecting the deaths of celebrities Heath Ledger, Anna Nicole Smith and Michael Jackson is prescription drug abuse triggered by chronic sleep deprivation.

Sleep deprivation, caused by insomnia or sleeplessness, is one of the most common heath complaints, and can lead to impaired mental and physical heath, or even death. After periods of reduced sleep, brain neurons may begin to malfunction, visibly affecting a person’s behavior. In sleep-deprived subjects, there is no activity in the temporal lobe of the cerebral cortex, which is associated with the processing of language (Ledoux 2008). Sleep-deprived individuals may exhibit slurred speech, stuttering, speaking in a monotone voice or speaking at a slower pace than normal.
They often experience behavioral or mood changes, such as anxiety, depression, fatigue, lack of interest or motivation and social or vocational dysfunction, leading to increased errors or accidents; decreased attention span; and tension, headache or stomach symptoms (Peters 2009). Extreme anxiety cause by poor sleep patterns may contribute to irrational and dangerous behaviors.

Heath Ledger
The late actor Heath Ledger—who received critical acclaim for his roles in The Patriot and Monster’s Ball, and a best actor nomination for Brokeback Mountain—suffered from chronic insomnia and anxiety. Furthermore, as his career soared, he was contending with the pressures of success and demands for increased creative output, while also dealing with a tumultuous personal life. Just prior to his tragic overdose in January 2008, the sleep-deprived and physically exhausted actor is believed to have been fighting off effects of walking pneumonia. The actor died from an accidental overdose of prescription medications, including painkillers, anti-anxiety drugs and sleeping pills.

Specifically, the New York City medical examiner’s office determined his death to be the result of “acute intoxication by the combined effects of oxycodone, hydrocodone, diazepam, temazepam, alprazolam and doxylamine.”

Ledger’s prescribed medications included painkillers, Vicodin (hydrocodone) and OxyContin (oxycodone); anti-anxiety drugs, Valium (Diazepam), Xanax (Alprazolam); sleeping agents Restoril and Euhypnos (Temazepam); and an over-the-counter antihistamine, used as a sleep aid (Doxylamine). Unconfirmed reports allege that Ledger also engaged in heavy drinking and used heroin and cocaine (Biskind, 2009).

Anna Nicole Smith
Because traditional sleep medications such as Ambien were ineffective, television reality star and former Playboy Playmate of the Year Anna Nicole Smith was prescribed the sedative chloral hydrate, which proved to be her undoing.

A seven-week investigation into Smith’s death in February 2007, found that the actress had died of “combined drug intoxications,” with the sleeping medication chloral hydrate being the “major component” in her death. The medical examiner reported a total of seven prescription drugs, usually prescribed for anxiety, depression and insomnia, were found in Smith’s bloodstream (CNN.com, 2007).

Smith reportedly had developed an increased tolerance to the sedative chloral hydrate and took about three tablespoons per dose, whereas the normal dosage is between one and two teaspoons. Synthesized in 1832, chloral hydrate, also known as “Mickey Finn” or “knockout drops” was developed for the specific purpose of inducing sleep. When used properly, and without the introduction of alcohol or other depressants, chloral hydrate is effective in easing sleeplessness due to pain or ­insomnia.

Today, the use of chloral hydrate has declined as other agents, such as barbiturates and benzodiazepines, have largely replaced it. In the death of Anna Nicole Smith, chloral hydrate became increasingly lethal when mixed with four prescription benzodiazepines: Klonopin (Clonazepam), Ativan
(Lorazepam), Serax (Oxazepam) and Valium (Diazepam). In addition, Smith had taken Benadryl (Diphenhydramine) and Topamax (Toprimate) and  an anti-convulsant GABA agonist, which likely contributed to the tranquilizer effects of the chloral hydrate-benzodiazepine combination (Furek, 2008).

Although the individual levels of any of the benzodiazepines in her system would not have been sufficient to cause death, their combination with a high dose of chloral hydrate led to her fatal overdose. The autopsy report indicated that chloral hydrate was the “toxic/
lethal” drug, but it is not known whether the chloral hydrate alone would have killed her. On Oct. 12, 2007, the Drug Enforcement Agency and California authorities served eight warrants in connection with Smith’s death. The investigation revealed that Dr. Khristine Eroshevotz, Smith’s personal psychiatrist, had written all 11 prescriptions, later called “pharmaceutical suicide” by a pharmacist who refused to fill one of Eroshevotz’s prescription order (Duke, 2009).

Smith’s former boyfriend Howard K. Stern and physicians Eroshevotz and Sandeep Kapoor were charged with “illegal conspiracy to prescribe, administer and dispense controlled substances to an addict.” Stern faces 11 felony counts, while the doctors were charged with six each (Duke, 2009)

Michael Jackson
Michael Jackson, the “King of Pop,” was the most recent celebrity in this tragic cluster. His death—reckless, senseless, irresponsible—has been ruled a “homicide” by the Los Angeles County coroner, who concluded that the 50-year-old singer died of an overdose of propofol, a powerful sedative given to help him sleep. Michael Jackson’s personal physician, Dr. Conrad Murray, administered Jackson the propofol prior to the singer’s death on June 25, 2009 (Duke & Simon, 2009).

Propofol (Diprivan) is an extremely dangerous drug that is administered intravenously in operating rooms and some office procedures as a general anesthetic, according to manufacturer AstraZeneca. The drug works as a depressant on the central nervous system, however, once the infusion is stopped, the patient wakes up almost immediately. Reportedly, Dr. Murray had been treating Jackson for six weeks prior to his death, administering 50 mg of propofol diluted with the anesthetic lidocaine via an intravenous drip to treat the singer’s insomnia. Concerned that Jackson may have been developing an addiction to the drug, Murray claims that he was trying to wean Jackson off the propofol by combining it with other drugs to help him sleep.

In the nine-hour period, prior to Jackson’s death, Murray administered the following drugs to Jackson: Valium, Ativan, Versed and propofol. In addition to his very public struggle with his own self-image, Jackson also apparently was privately struggling with drug problems. In 2007, according to the Associated Press, an L.A pharmacy sued him, claiming he owed $100,000 for two years’ worth of prescription meds …” (Gates, 2009).
Spanning three unique demographic groups, the careers of Michael Jackson, Anna Nicole Smith and Heath Ledger touched our lived in unusual ways. All were gifted and talented, but in the end, their lives intersected at the juncture where sleep deprivation and drug overdose defined their final days. Like a perverse reality show this tragic saga continues. Each decade we observe our iconic celebrities self destructing in full view of their fans and a curious public—note the deaths of Elvis Presley, Marilyn Monroe, Janis Joplin, Kurt Cobain and countless others. We need to stop the madness and view this as a “teachable moment” where we renew our commitment to treatment and carry the message of recovery to those who need it most.

Maxim W. Furek, MA, CAC, ICADA, is a Director of Garden Walk Recovery, an organization “promoting wellness through drug  prevention and education.” He is the author of The Death Proclamation of Generation X: A Self Fulfilling Prophesy of Goth, Grunge and Heroin. He can be reached at www.maximfurek.com.

References
Biskind, P. (2009). “The Last of Heath.” Vanity Fair. Issue No. 598.
Brain Activity is Visibly Altered Following Sleep Deprivation (2002). UC San Diego Medical Center. Retrieved from http://www.ask.com/bar?q=sleep+
deprivation+research&page=1&qsrc=0&ab=4&u=http%3A%2F%2Fhealth.ucsd.edu%2Fnews%2F2000_02_09_Sleep.html
Duke, A. (2009). New charged filed in investigation of Anna Nicole Smith death. CNN.com/entertainment.
Retrieved from http://www.cnn.com/2009/SHOWBIZ/music/08/24/michael.jackson.propofol/index.html
Furek, M. (2008) The Death Proclamation of Generation X: A Self-Fulfilling Prophesy of Goth, Grunge and Heroin, i-Universe: Bloomington, IN.
Furek, Maxim W. (April, 2009). “What Really Killed Anna Nicole Smith?” Counselor, The Magazine for Addiction Professionals. Vol. 10, No. 2.
Gates, D. (2009). Finding Neverland. Newsweek. June, 27, 2009.
Green, B. (2009). Michael Jackson, Elvis Presley, and Anna Nicole Smith: Death is the Prescription, how many more? Retrieved at http://www.articlebrain.com/Article/Michael-Jackson—Elvis Presley—and Anna-Nicole-Smith—Death-is-the Prescription—how-many-more-/34674
Ledoux, S. (2008). The Effects of Sleep Deprivation on Brain and Behavior. Retrieved from http://serendip.brynmawr.edu/exchange/node/1690
Peters, B. (2009). What is Acute Insomnia? About.com: Sleep Disorders. Retrieved from http://­sleepdisorders.about.com/od/commonsleepdisorders/a/Acute_Insomnia.htm
Source: Jackson’s doctor gave drug authorities believe killed him. Retrieved from http://www.cnn.com/2009/SHOWBIZ/Music/07/27michael.jackson/index.html

"The purpose of these sacraments is to purify, and to open the road. When it opens, it's as clear as the blue sky, and the stars at night are as bright as suns."—Aurelia Aurora Catarino (Mazatec shaman)

Salvia, a sprawling perennial herb found in the Sierra Mazatec region of Mexico, has been used by the Mazatec shamans for thousands of years to produce visionary states of consciousness during spiritual healing sessions (Lewis, 2002). Today, Salvia divinorum, known on the street as “Sally D” or“Magic Mint,” is believed to be the world’s most potent hallucinogenic herb and has emerged as one of the latest recreational drugs of abuse. The Substance Abuse and Mental Health Service Administration’s (SAMHSA) National Survey on Drug Use and Health Report estimated that 1.8 million individuals have used Salvia divinorum in their lifetime, and approximately 750,000 used the psychedelic in the past year.

On Feb. 8, 2007, the front desk staff at the Seminole Hard Rock Hotel and Casino in Hollywood, Fla., made a desperate 911 call: “We need assistance to room 607 at the Hard Rock. It’s in reference to a white female. She’s not breathing and not responsive ... actually, it’s Anna Nicole Smith.”

Anna Nicole Smith was found lifeless in room 607 after bodyguard Maurice “Big Moe” Brighthaupt called the hotel front desk from Smith’s sixth floor room. Brighthaupt, a trained paramedic, administered CPR before Smith was rushed to Memorial Regional Hospital at 2:10 p.m. The TV reality star and former Playboy Playmate of the Year was pronounced dead at 2:49 p.m. (CNN.com, 2007).

The 2006 arrest of San Diego Chargers starting safety, Terrence Kiel, exposed the popularity of a relatively obscure drug mixture known as “lean.” Kiel was arrested for allegedly shipping at least two parcels of Prometh prescription cough syrup to Texas and charged with two felony counts of transporting a controlled substance and three counts of possession for sale of a controlled substance (Associated Press, 2007). A one-pint bottle of “lean” has a street price of between $200 and $325, but can fetch as much as $500 (National Public Radio, 2001).

Usually purple in color, lean is a drink made by mixing codeine cough syrup with soda, wine or juice. The concoction — also called syrup, Barr or purple drank — generally causes users to lose their balance and lean to the side.