Why couldn't Michael Jackson sleep?

What KNOWLEDGE creates : Michael Jackson: What a tragic ending teaches

It has been clear since Monday: The "King of Pop" died of a mixture of sleeping pills and sedatives that his family doctor administered to him. According to excerpts from the interrogation protocols and laboratory tests, Michael Jackson had only been able to sleep for months when his family doctor gave him an infusion of powerful medication. Because normal sleeping pills and Valium no longer worked, the pop star had been on lorazepam and midazolam for a long time.

These substances, which like Valium belong to the addictive “benzodiazepines”, are actually intended for the treatment of severe epileptic seizures and for short anesthesia. But over time Jacko got used to these chemical clubs, so the dose had to be increased further and further. Eventually his family doctor, Conrad Murray, gave him propofol, which is otherwise used for general anesthesia in the hospital. Michael Jackson called the white fat emulsion his "milk" and, according to the family doctor, asked for it every evening.

On the night of his death, the doctor administered infusions of lorazepam, midazolam, propofol and possibly other sleeping pills to his severely drug-addicted patient. When the ambulance arrived, Jackson was no longer breathing. Murray is now under investigation for manslaughter. Apparently he did not inform the emergency doctors that he had administered the life-threatening medication to his patient.

The tragic end of the "King of Pop" was certainly an extreme case - however, drug abuse has long spread in all layers of society. Well-known pill excesses by stars like Jamie Lee Curtis, Amy Winehouse, Heath Ledger or Anna Nicole Smith are only the tip of a huge iceberg. In the USA, the alternating use of wake-ups ("uppers") and sedatives ("downers") is part of the daily ritual of many managers, students and pupils. Over 15 million Americans are considered drug addicts and the death toll is twice that of illegal drugs. Around 1.7 million people in Germany are drug addicts, and as many again are considered to be at risk.

For young, active people in particular, drugs seem to be the perfect aid for fine-tuning social issues. If you are actually too tired for the disco in the evening, you can use a little wake-up call. In order to be fit for work again in the morning, there is another tablet to help you fall asleep. Not only medical students swear by Ritalin and similar concentration enhancers before exams. If you have to work through the night, you can take Modafinil, a drug against pathological sleep addiction (narcolepsy). The Alzheimer's drugs donepezil and piracetam are used for general brain doping. Anti-obesity agents and all kinds of appetite suppressants are particularly popular with young women - in practice, many “uppers” and “neuro-enhancers” also have appetite inhibition as a side effect.

In social doping, like doping in sport, there are professionals and amateurs. Stars like Michael Jackson can get drunk on intravenous anesthetics at home with the help of their private doctors. In the semi-professional area, normal, prescription pills dominate. If you can't even get the wrong recipes, you have to get yourself into day or night form with coffee, Red Bull and alcohol.

In contrast to this wood class of social doping agents, drugs suitable for abuse have one thing in common: they all require a prescription. As with doping in sport, doctors therefore have a key position - both in promoting drug abuse and in combating it. Instead of pulling out the prescription pad every time the patient's mood swings, doctors have to prescribe drugs that are dangerous to abuse as restrictively as possible. And those who administer anesthetics to an obviously addicted, barely sane patient like Michael Jackson must be severely punished - otherwise the imitators from the amateur league can no longer be stopped.

The author is the director of the institute and professor for medical microbiology in Halle. Photo: J. Peyer

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