Well that didn't take long after Michael Jackson died, did it?

Here we go again. Celebrity dies at a slightly unusual age from an acute failure of essential bodily physiological competence and I’m thinking about drugs. My man @abelpharmboy sent me a note yesterday anticipating the same thing I did when learning of Michael Jackson’s heart attack and demise. [Update: Abel Pharmboy’s post on Demerol and cardiac arrest] Now of course our resident expert in the relevant physiological systems cautioned that I was perhaps jumping the gun. To which I confessed a hammer/nail orientation. Still.
Sure enough, at least one person close to MJ is railing about the drugs.

Jackson family lawyer Brian Oxman confirmed Jackson may have had trouble with prescription drugs as he prepared for his London show.
“This was something which I feared and something which I warned about,” Oxman said on CNN. “I can tell you for sure that this is something I warned about. Where there is smoke there is fire.”

Remember what we learned from the tox report on Heath Ledger?

this report is just in from AP on Heath Ledger’s toxicology report:

The cause of death was “acute intoxication by the combined effects of oxycodone, hydrocodone, diazepam, temazepam, alprazolam and doxylamine,” spokeswoman Ellen Borakove said in a statement.

Well, the early allegations about what Michael Jackson may have been taking point to similar issues.

The star had been taking prescription painkillers (sic) including anti-anxiety drugs Xanax, Zoloft and painkiller Demerol in recent months, sources close to Jackson told Life & Style. The insider close to the star said he took a suspected overdose of drugs on Thursday morning, which caused respiratory and cardiac arrest.

Now we will have to wait for additional specifics because Zoloft (sertraline) is a selective serotonin reuptake inhibitor which is a class which does not have a big reputation for causing acute respiratory depression or cardiac arrest. I’m not finding a huge amount of work but there is a report of a protective effect in the elderly here and a finding of no increased risk here.
Xanax (alprazolam) however is a benzodiazepine and Demerol (meperidine, piethidine) is a mu-opiate receptor agonist like morphine and other narcotic painkillers and also has some anticholinergic properties. These drugs, especially if combined (see review on respiratory interactions), make for top suspects given that the tox reports eventually confirm that MJ actually took them. A few bits on cardiac arrest in opiate abusers are here and here.
sigh.