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08.30.09

Did Jackson Drug Himself?

Jackson's doctor's defense team believes the singer might have taken sleep drugs on the sly, reports Gerald Posner, which could have led to an overdose when his doctor administered more.

The Los Angeles County Coroner's Office confirmation Friday that Michael Jackson's death has been classified a homicide cited two drugs: the antianxiety medication lorazepam and the now-notorious anesthetic propofol. According to search-warrant affidavits, Dr. Conrad Murray, the main target of the police investigation into Jackson’s death, admitted administering both those medications, and others, to Jackson in the hours before his death.

But this official homicide announcement did not cause a panic in the law offices of Dr. Murray’s laywers, the Houston-based firm of Stradley, Chernoff & Alford. The coroner’s repeated refusal to release all the results has fueled speculation within Dr. Murray’s camp that Los Angeles investigators might be hiding or downplaying some findings that don’t fit the prosecution’s theory of the case.

“You can’t tell from the tox report if the medication was injected, the way Murray would have administered it, or swallowed, the way Jackson would likely have ingested it.”

"Come clean with it and let's get on with the process," says Ed Chernoff, the lead attorney. “They have come up with a conclusion and they have done their investigation to support that conclusion.”

A source familiar with the defense strategy told The Daily Beast that the coroner “was playing games” by failing to release the complete toxicology results as well as the final medical examiner’s report. The defense team has already retained a forensic pathologist, but that expert has been hampered by the coroner’s refusal to release detailed lab results. “There’s no question that not having the specifics, the quantities, whether the drugs were found in the blood, urine, bile, or ocular fluid, you can’t do your work without it,” says Cyril Wecht, former chief medical examiner of Allegheny County, Pennsylvania, and one of the nation’s leading forensic pathologists.

In this case, the devil is most certainly in the details. In a story published on July 27, I wrote, “The Daily Beast was told by a source familiar with Jackson’s toxicology report that traces of at least six prescription drugs were found in his body.” Now, nearly a month later, the coroner has confirmed that Jackson’s tox report identified at least six drugs in him when he died. In addition to lorazepam and propofol, the tox report also mentions midazolam, an extra short-acting benzodiazepine derivative used for insomnia, the sedative diazepam, a local anesthetic lidocaine and a stimulant, ephedrine. One source familiar with the investigation expects that the final report will reveal at least one more drug, the antianxiety medication Xanax, and possibly one or two others.

The coroner’s failure to release the precise quantities of these drugs, one source close to the investigation believes, is important because it’s the only way independent experts can determine whether Dr. Murray was truthful the night he first spoke to the the police and provided the details of what had transpired.

Dr. Murray told police he had given the pop star 25 mg of propofol at 10:40 a.m., and then found him not breathing at noon. A medical examiner should be able to determine whether the levels found in Jackson’s blood were consistent with what Murray said. "Or at least make an approximation,” says Wecht. A law-enforcement source told the Los Angeles Times on Friday that toxicology reports had prompted investigators to suspect that Murray gave Jackson more propofol than he told police. “If that’s the case,” says Ed Chernoff, “why don’t they release the full tox report?”

Moreover, Murray, in some six hours of interviews with detectives, said that he had given Jackson a mix of other sleeping aids before finally administering the propofol. That was after nine failed hours of trying to get Jackson to sleep, and was, according to the search-warrant affidavit, at the singer’s insistence. Among the medications Murray gave Jackson besides the propofol was 4 milligrams of lorazepam, split in even doses at 2 a.m. and again at 5 a.m. Because of Jackson’s easy access to drugs prescribed by other physicians, some of which were found in a search of the house by LAPD detectives, a medical examiner, who requested anonymity, speculated to The Daily Beast that Jackson could have himself, without informing their client, self-administered drugs during the course of the night in an effort to get to sleep.

According to the search-warrant affidavits, by the time Murray became Jackson’s physician six weeks before the singer died, Jackson seemed accustomed to having propofol administered in order to cope with his chronic insomnia. He referred to the anesthetic as “my milk” (it has a milky appearance) and nicknamed the lidocaine, which reduces the burning sensation of the propofol , as the "anti-burn." Murray thought the singer was addicted. As a result, he tried weaning Jackson off the propofol as his primary sleep aid, and two days before the singer’s death, June 23, had managed to get him to sleep with other prescription sleep aids, but for the first time without using the powerful anesthetic.

Unknown to Murray, according to sources familiar with the defense, on June 21 Jackson aides had reached out to a nurse practitioner, Cherilyn Lee, who he had met in January. Since Jackson’s death, Lee has claimed in the media that that she told the aides at that point to bring Jackson to the hospital—advice they ignored. (Murray told the police, according to the search-warrant affidavits, that when he learned about Lee, he came to believe she provided Jackson propofol, something she adamantly denies.)

Over the more than nine hours leading up to Jackson’s death, since the other sleep aids Murray administered did not work, evidently Jackson became increasingly agitated that he was not getting to sleep. During the four to six times that Jackson woke up, did he decide to take pills on his own so he would sleep? Any self-medicating by Jackson would of course have caused Murray’s calculations about the safe-versus-dangerous doses of his own dispensing to be critically off the mark. Lorazepam, the drug named by the coroner in Friday’s press release as being a contributing factor in the deadly drug mix, was available to Jackson at his house, prescribed by another physician, according to the search-warrant affadavits. Could Jackson have accidently contributed to his own death? Whether Jackson did in fact self-medicate when Murray was not present could be determined by the levels of the specific drugs in his system versus what Dr. Murray told the police he administered.

“There’s a margin of error in toxicology reports,” says Dr. Wecht. “It’s not like nuclear DNA. If the parameters in the coroner’s final report are tight and narrow, then the Murray defense team will have a difficult time arguing that, but if the quantities found of the original drugs, or the metabolites [the drugs that metabolize quickly in the body] are significantly higher than what would be expected from what Murray admitted giving, they have a good defense that Jackson might have self-administered. You can’t tell from the tox report if the medication was injected, the way Murray would have administered it, or swallowed, the way Jackson would likely have ingested it. If this goes to trial that might be the essence of the defense.”

“He's Michael Jackson,” says one person familiar with the situation. “He’s accustomed to getting his own way. How upset do you think he might be that he wasn’t getting to sleep and that he knew better than his new doctor what would put him out? He wanted to get to sleep ‘now,’ not in 10 minutes.”

“Why are they holding back,” asks a source close to the defense team. “They aren’t coming clean because something they have come up with doesn’t fit into their neat little theory. But eventually they are going to have to go public and independent experts are going to examine those results and determine who’s telling the truth and what caused Michael Jackson to die.”

Calls to the Los Angeles coroner’s office for comment went unanswered.

Gerald Posner is The Daily Beast's chief investigative reporter. He's the award-winning author of 10 investigative nonfiction bestsellers, ranging from political assassinations, to Nazi war criminals, to 9/11, to terrorism. His latest book, Miami Babylon: Crime, Wealth and Power—A Dispatch from the Beach, will be published in October. He lives in Miami Beach with his wife, the author Trisha Posner.