Did You Hear That Michael Jackson Died?

Jeralyn wisely decided not to write about "the DEA jumping into the Michael Jackson death investigation (ridiculous)" but I have no shame. According to this article, "the agency's involvement in the Jackson case suggests authorities are looking into whether drugs came from out of state." It's more likely (as the article also notes) that the DEA is interested in the conduct of Jackson's physicians.

According to the article, a criminal investigation could focus on whether prescription medications played a role in Jackson's death, and if so, whether doctors overprescribed medication, prescribed drugs he didn't need, or wrote prescriptions for Jackson under an assumed name. Ultimately, the most likely explanation for the DEA's involvement is that Jackson was a high profile celebrity, making the investigation a fun digression from the routine pursuit of drug smugglers and dealers.

Given the possibility of a criminal investigation, LAPD is taking heat for its failure to secure the scene of Jackson's death. [more ...]

Why didn't police seal the mansion where he had been living? Why were moving vans seen at the home, and were any items removed before police wrapped up their search? Why didn't they get immediate search warrants? Why did they tow away a doctor's car right after the death but not declare the home a crime scene?

The failure to request "immediate search warrants" is understandable. There is nothing inherently suspicious about a death by cardiac arrest. Jackson was attended by a doctor, and it wasn't immediately clear that the doctor performed CPR for "up to a half-hour" before requesting an ambulance. If any facts established probable cause to believe that a crime was committed, those facts were probably not immediately apparent to the police.

On the other hand, why it took four days to realize that drugs may have contributed to Jackson's death, and to obtain a warrant to search his home for those drugs, is less than clear. It's also odd that the police towed the doctor's car "the evening of the death to look for potential evidence" but didn't secure the home as a potential crime scene. Obsessive media coverage of Jackson's death may provide some answers to these questions for those who manage to sustain their interest.

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    California has a lot of problems (5.00 / 2) (#5)
    by inclusiveheart on Fri Jul 03, 2009 at 09:42:23 AM EST
    right now.  Drug addled celebrities - if this is even the case - are not new and honestly not as high on my list of priorities as things like education, affordable healthcare for people who aren't celebrity elites and economic opportunity again for people who aren't celebrity elites.  The amount of money this whole things is going to cost LA County is probably going to be stunning.

    Just in plastic surgeries alone Michael Jackson probably shaved years or decades off of his life span.  It seems to me that unless there is something really more sinister than a guy opting to abuse his body in many, many ways going on, I just don't see the need.  I think dying of a heart attack from abusing onself for years is enough of a "message" to the public about the risks of drug use and from my perspective plastic surgery too.  A person's body can only take so much.  Lengthy investigations into doctors and the origins of prescription drugs seems to miss the point entirely - the point being that the dead person in this case was a willing participant and has paid the ultimate price for his lifestyle.  Why put everyone who ever gave him an asprin in jail too?  Just seems stupid and wasteful to me.

    Exactly. (5.00 / 2) (#24)
    by JamesTX on Fri Jul 03, 2009 at 03:34:35 PM EST
    I had mentioned celebrities are not "normal" patients. He probably needed chronic pain treatment with all the surgery he had been through, some of which appears to have been ... botched! People in this class should not be used as examples or "model patients" for purposes of arguing policy. They have unimaginable resources and power, and nothing about them is remotely similar to the average patient. They are not our collective problem. As it stands now, nobody but someone of MJ's caliber could even obtain the drugs that killed him.

    Yes and beyond the surgeries which (5.00 / 1) (#27)
    by inclusiveheart on Fri Jul 03, 2009 at 06:23:49 PM EST
    started I think when his hair caught on fire making a Pepsi commercial and may have a lot to do with his pain problems, he might have had some other diseases.  I imagine he came across some less than ethical physicians at some point or another, but there is a very real chance that he had so many health issues that everyone who ever examined him had a good reason to treat him in the manner that they did - that they did what they did in good faith and in the interest of good medicine for that particular patient.

    In any case, you're right that most people don't have the means or the importance to be treated the way celebrities are.  The reality is that the entertainment industry is also a factor in all of this - producers can't afford to lose a day here or there so they keep their stars on drugs or whatever as they are cheaper than lost days.  But I've never heard of a studio or production company busted for that practice - which is really at the heart of the problem imo.


    Same Old (5.00 / 1) (#7)
    by squeaky on Fri Jul 03, 2009 at 10:16:18 AM EST
    Think Billie Holiday. High profile celebrity drug busts are grist for the WOD publicity mill:

    In the spring of 1947, Jimmy Fletcher heard from his bosses at the Federal Bureau of Narcotics that it might be a convenient time to visit Billie Holiday at home. Her manager, a former fight-fixer, whoremonger, and running dog in Al Capone's pack, had offered up the celebrated Negro "torchchanteuse" and notorious dope fiend as grist for Harry Anslinger's publicity mill.

    Anslinger, the bureau's first and only commissioner, was the public face of America's war on drugs, and he hustled as hard, if not as well, as his envied rival J. Edgar Hoover. Splashy arrests kept the congressional purse holders mindful of who stood between America's schoolchildren and the ravening scourge of narcotics. For doers of the commissioner's bidding, Billie Holiday was "an attractive customer," a reliable source of repeat business.


    Also (none / 0) (#9)
    by squeaky on Fri Jul 03, 2009 at 10:45:24 AM EST
    AEG CEO Randy Phillips purportedly stated that the $17.5 million policy issued by Lloyd's of London didn't cover death by natural causes and will fall far short of the money spent on Jackson's advance, producing the show and some of Jackson's debt and staff expenses.

    raw story

    But the $17.5 mil tour insurance policy taken out by his promotors did cover overdose as cause of death.


    AEG Live... (none / 0) (#17)
    by MileHi Hawkeye on Fri Jul 03, 2009 at 11:30:17 AM EST
    ...is owned by Phil Anschutz, who is not used to being told "no".  His political clout and growing media holdings give him the bully pulpit to spin and apply pressure to resolve things to his liking.  

    Personally, as the man who killed a great Colorado tradition in the Ski Train, I won't lose any sleep should he take it in the shorts.  

    More on the insurance issue.

    AEG Live chief executive Randy Phillips told the magazine in May that the company was well-insured, and Bermuda-based insurer Validus Holdings Ltd. said a group of insurers was covering the concert series through the Lloyd's insurance market, including its subsidiary Talbot Holdings Ltd.

    In a video news conference this month, Phillips acknowledged that the company had been able to insure only 23 of the 50 dates. The remainder, industry experts say, were likely self-insured.

    The insurance market was receptive to the Jackson tour when the deal was announced in March, according to a Reuters news agency story, but cooled after things grew from an initial offering of 10 concerts.

    That leaves AEG exposed to big losses if the policy was hinged on nonperformance issues, for which Jackson was well-known, or pre-existing medical conditions that an autopsy is likely to reveal, if there were any.

    Yeah (none / 0) (#18)
    by squeaky on Fri Jul 03, 2009 at 11:41:44 AM EST
    They are heavily invested in the death being pronounced as "natural".  Then they do not have to pay out the big bucks.

    OOPs (none / 0) (#22)
    by squeaky on Fri Jul 03, 2009 at 01:54:35 PM EST
    I thought you were referring to AIG, not AEG. In that case Overdose as cause of death is the most desirable outcome so AEG can collect full payout from their insurer.

    Jackson engaged in self mutilation. (5.00 / 1) (#8)
    by Salo on Fri Jul 03, 2009 at 10:38:59 AM EST
    physical, mental, emotional.  

    It's remarkable that he didn't die in his mid 30s. He must have had a lot of stamina.

    First, do no harm (5.00 / 1) (#19)
    by Dadler on Fri Jul 03, 2009 at 11:58:18 AM EST
    Second, do no healing.  Third, lawyer up.

    Triple play!

    Legalize, regulate, educate.

    My back hurts (none / 0) (#28)
    by gentlyweepingguitar on Fri Jul 03, 2009 at 11:39:15 PM EST
    I have degenerative disc disease and a little arthritis in my back. I feel pain all the time. What I would give for a few Vicodins. My doctor won't give them to me. Doesn't want me to get hooked. Tells me to take Advil. It's so not fair. I want those doctors busted.

    This is hardly (none / 0) (#1)
    by JamesTX on Fri Jul 03, 2009 at 08:36:38 AM EST
    a digression from routine activities for the DEA. The DEA is obsessed with prescription drugs now. First of all, doctors usually don't have guns and airplanes, making them safe, easy and fun to apprehend. Second, the DEA has among its duties to the country continuing service to the bottom line of the pharmaceutical industry, and maintenance of the price structure of a highly profitable international illicit drug market. Doctors prescribing opioids threaten those goals directly, thus they are very interested!

    Several interesting tidbits have emerged in the media frenzy. The story about MJ and the Diprivan could mean he may have been withdrawing from narcotics and couldn't sleep. The "hot on one side and cold on the other" stuff is, of course, classical opiate withdrawal symptoms. I heard somewhere (probably a rumor) that they actually did find Diprivan at the scene. If that is true, and it turns out to be Diprivan, then opioids, as usual, didn't kill him! But, you can bet that is how it will be painted.

    The DEA... (none / 0) (#2)
    by kdog on Fri Jul 03, 2009 at 08:56:11 AM EST
    circling like vultures, ready to pounce on a tragedy and pile on some more misery.  Sounds like their m.o.

    Whatever dope he was on, he made his choices and he paid the price for the damage done.  But the DEA won't leave it at that...somebody always has to pay and be punished.  Lame.

    I Don't Have a View About DEA's Involvement (none / 0) (#3)
    by BDB on Fri Jul 03, 2009 at 09:28:54 AM EST
    but if doctors overprescribed drugs or prescribed the wrong drugs, then they need to be investigated.  Similarly, if the doctor worked on Jackson for 1/2 hour before calling a fricking ambulance.  Although generally I'd rather such investigation be centered on medical licenses than some sort of criminal action (which is not to say that at some point doctors' conduct can't rise to criminal because it can and for all I know in this case did).

    If physicians have an obligation to treat patients and heal them, they can't abandon that role to be drug pushers to celebrities.   In some cases, the amount of drugs provided is staggering.  An example from the article linked above:

    1994: Three doctors--Dr. William F. Skinner, former director of the chemical dependency unit at St. John's Hospital and Health Center in Santa Monica; Dr. Michael Roth and Dr. Michael S. Gottlieb, an immunologist, were reprimanded by the California Medical Licensing Board for prescribing huge amounts of drugs to Elizabeth Taylor: more than 1,000 prescriptions in five years for 28 different drugs including Demerol, Percocet (painkillers), Valium and methadone. It was seen as a minor reprimand at the time.

    No they don't... (5.00 / 1) (#4)
    by kdog on Fri Jul 03, 2009 at 09:37:51 AM EST
    if any drugs were over-prescribed I'm confident it was at Jackson's request...he was the customer, and the customer is always right, no?

    When I'm slinging plumbing supplies, and a customer insists on buying a product that doesn't fit their application, I'll tell them it is not what they need to fulfill my professional duty, but the final call is up to them, and I'll sell 'em the wrong sh*t all day long if they insist...I don't see why it should be any different for doctors, they have a duty to recommend the right course of treatment, but the final say is with the patient, if they want "x" give 'em "x"...it's called freedom.


    No (5.00 / 1) (#11)
    by TeresaInSnow2 on Fri Jul 03, 2009 at 10:48:16 AM EST
    he was the customer, and the customer is always right, no?

    No, doctors have a responsibility to say no when no is the appropriate answer.

    That is why doctors can lose their license for overprescribing meds.


    Sure (none / 0) (#12)
    by squeaky on Fri Jul 03, 2009 at 11:00:02 AM EST
    The doctor would lose his or her business if they stopped listening to their customers. It is inconceivable that a prozak doc, or whatever they are doling out these days, would ever say something like:

    Prozak? No I will not prescribe it to you. You just need more love and less stress in your life. join a gym and a dating service. Volunteering is also a good way to meet like minded people.

    The hypothetical doctor would not have to worry about the DEA, because he or she would be out of business.


    I'm guessing you don't know (5.00 / 1) (#13)
    by andgarden on Fri Jul 03, 2009 at 11:02:44 AM EST
    many doctors, because that attitude is not uncommon in my experience.

    lol (none / 0) (#14)
    by squeaky on Fri Jul 03, 2009 at 11:13:39 AM EST
    Sure primary care, family type doctors. But there are specialists whose only function is to write prescriptions (and collect fees), that is why you go to them.

    100% legal and the perfect vehicle for pharmaceutical companies to enrich life for many through chemical engineering.


    I have no problem (none / 0) (#15)
    by andgarden on Fri Jul 03, 2009 at 11:23:03 AM EST
    with better living through chemistry. And that's just the system we have for now.

    No Problem Here Either (none / 0) (#16)
    by squeaky on Fri Jul 03, 2009 at 11:26:23 AM EST
    All drugs should be legal, imo.

    Haven't seen that movie, (none / 0) (#21)
    by brodie on Fri Jul 03, 2009 at 01:49:23 PM EST
    but it looks like that character was based on the real life Dr "Feelgood", one Max Jacobson, a NY doctor to the stars known as the emphetamine go-to guy for celebs.

    But let's not forget that 15 yrs before that movie, the Beatles had told about MJ/Feelgood in their Lennon-penned Revolver album song "Doctor Robert."  Though JL claimed it was about himself, since in the early days he was the guy who carried the pills when they traveled.


    Celebrities like MJ will always (5.00 / 1) (#6)
    by JamesTX on Fri Jul 03, 2009 at 10:03:24 AM EST
    get the absolute best of everything. They always will, because they are in financial control. Pain treatment with opioids is severely rationed in this country, primarily by socio-economic status. The fact that celebrities like MJ get the first cut of that ration is simple unavoidable economic law under these conditions. What little is available to patients overall will first go to those who can pay the most, just like all other rare and expensive forms of medical treatment will go to them first.

    The doctor-patient relationship is simply not typical in these cases, as the doctor (as in this case) can be employed entirely by one patient. One thing that leads to the "enormous" amount of medicine these people get is the enormous amount they pay! It is the typical patient who gets little essentially because they cannot pay for more, not because there are inherent reasons for denying it. It is not the celebrities who get "extreme" amounts.

    Stars like MJ are also special people. They have medical needs which are not typical. Medical decision making in these cases is not the same as with average people. Like the sports physicians who keep the athletes on the field even when injured, these types of doctors have to consider the enormous importance of the patient's performance (not only to others but to the patient themselves), where in normal cases the person could simply be told to go home and rest.

    Chronic pain treatment is severely rationed, thus celebrities will be among the few who get it. Chronic pain treatment with opioids usually involves large doses because they have built up tolerance over time. Opioid "dose" level is used by prosecutors and the DEA to hype their cases, but medical professionals in pain care can tell you that dosages vary tremendously based on length of treatment and individual differences. What appears to be a "huge" dose can actually be quite a reasonable dose under certain circumstances. Federal prosecutors make much of dose in their trials, and encourage juries to compare dosage to their own experience. For a typical person denied pain care, one Vicodin tablet is a normal dose, and four a day looks like a tremendous amount. The fact is, though, that a chronic pain patient who is treated over time may actually need ten times that amount of narcotic (not acetominophen, which we discussed earlier), and can quite safely tolerate it.


    I'm with you (5.00 / 1) (#10)
    by TeresaInSnow2 on Fri Jul 03, 2009 at 10:45:35 AM EST
    I think all drugs should be freely available to individuals -- at their own request, at their own risk.

    However, doctors have a special responsibility.  They are supposed to be the EXPERTS and thus when a doctor prescribes/recommends a drug, the implication is that it's appropriate -- even if the patient requests it.

    The nurse practitioner who spoke on CNN said that a doctor actually told Jackson that diprivan was safe.  If so, that is the height of irresponsibility

    It's wrong for doctors -- in their special role -- to overprescribe meds.  If nothing else, they should lose their license for it.  They SHOULD be able to resist a patient's request.  Losing their minds over a celebrity is clear evidence  that they aren't clear enough minded to practice medicine.



    That's not exactly (none / 0) (#23)
    by JamesTX on Fri Jul 03, 2009 at 03:23:34 PM EST
    what I heard. The nurse said, in the encounter where he was desperately begging for the drug, that MJ told her a doctor had told him it was safe if somebody is there to "wake me up". Apparently, if there was a doctor who told MJ something, the statement was at least conditional. It sounds like MJ may have heard what he wanted to, taking great liberties (or not understanding) the conditions under which it is safe. As I understand, it is safe and it is very commonly used if you are in a hospital or other location being monitored, and there are emergency personnel and respiratory equipment nearby. It sounds like that may be what MJ was told, and he reduced it to "somebody there to wake me up" in his haste to get the drug.

    I am suspecting it is going to turn out there is no prescription attached to the Diprivan, if that is what killed him. He probably bought it "on the street", which in his case means he paid a large sum of money to obtain it illegally.


    looked up diprivan (none / 0) (#25)
    by Fabian on Fri Jul 03, 2009 at 03:55:20 PM EST
    on the FDA website.

    It's probably what they used on me the only time I had general anesthesia.  (I remember being shifted to the operating table and nothing else.  Diprivan acts within a minute.  Very fast.)  It's used in operating rooms - the kind of place that you are surrounded by medical professionals and medical support equipment and services if you should need them.

    I'm trying to figure out why anyone would want an instant knockout drug, especially one that needs to be administered intravenously.  Sheer desperation coupled with ignorance?


    Diprivan (none / 0) (#26)
    by Fabian on Fri Jul 03, 2009 at 04:14:03 PM EST
    is - used alone - a reasonably safe drug.

    In combination with other drugs?  Not safe.

    I'm not always convinced doctors understand the drugs they prescribe.  I'm always skeptical that anyone without medical training understands the drugs that they take.