Michael Jackson and Diprivan

I was an anesthesiologist for ten years, before my opiate dependence destroyed that career. During the tail end of my time working with mega-substances I had occasional days where I was desperate for something to ease the symptoms of withdrawal, primarily on the weekends when I was unable to go to work– as work was where the drugs were! I had no aversion to needles; in fact, by that time I had a positive association with them (and still do– an example of simple classical conditioning at work, just like the salivating dogs of Pavlov). I ‘used’ a couple different medications to help ease the pain; midazolam, reglan for nausea, diazepam for anxiety… but I never had any desire to inject Diprivan (aka propofol), the anesthetic induction agent supposedly found on the premises of Michael Jackson’s estate, and the drug that his nurse claims he used to beg for.

I first saw a report a few days ago when one of his ex-nurses was being interviewed; she said he had severe insomnia and begged her for that substance, but she would not give it to him. She didn’t mention that it would have been very difficult for her to give it to him even if she wanted to– it is used only intravenously, and only in monitored settings, so I don’t know how she would have obtained it without stealing it from a surgical center. I can’t just call up a drug supply house and say I want propofol for my clinic! I then heard today about the police finding the drug at Neverland. Wow– I can’t understand how a person could get to the point of using that ‘medication’. Again, it is an ‘induction’ agent– not ‘induction’ like a Suboxone induction, but an ‘anesthetic induction’– the process where a drug is injected that initiates a general anesthetic. It is also used in intensive care units to keep people unconscious while they are on ventilators, or given for short surgical or painful procedures like shocking the heart to ‘convert’ an abnormal heart rhythm.
I remember reading years ago that there was some theoretical abuse potential among anesthesiologists because the drug, when injected IV, induced a state of ‘positive well being’. The downside was that the ‘positive well being’ only lasted a few minutes, until the hypoxia from not breathing killed the person. Overall, not the best drug to mess with. We had a very talented surgeon in my home town who committed suicide with the medication a few years back; there was no doubt about his intention with the drug.
I often find the witch-hunt mentality to be a bit much in these types of cases, when everyone is looking for a doctor to blame for getting Mr. Jackson to the state he ended up in. But in this case, if some doc turned Michael Jackson onto propofol as an agent to help him get some sleep, that doctor is so far ‘over the top’ that he deserves whatever he gets– and should never be allowed to prescribe again! I had assumed that the cause of death was opiates, and perhaps that will still be the case– and if that is the case, I am less inclined to condemn the doctor(s) who treated him. I can only imagine how hard it would have been to say ‘no’ to someone of his power, as he talks about how the years of dancing have caused chronic pain in his knees, hips, and back… it would have been very difficult to say ‘no’, especially since you would tend to assume that the King of Pop had people to watch out for his well being.
But he didn’t. And instead of finding joy and friends through the use of his remarkable talents, it sounds as if he was deeply troubled, to the point of requiring a general anesthetic in order to escape from wakefulness for a blessed few hours. I would guess that every addict has some sense of what Michael Jackson’s life was like; the feelings and thoughts of addicts being so identical from one person to the next.
Sleep well, Michael. Wherever you are, I hope you are finally sleeping well.