Regarding the Michael Jackson case, some medical information emerges that deserves comment.
The artist died of respiratory arrest having a combination of opiate and benzodiazepine substances in his body, as well as an antidepressant. Lately, however, it also emerged that he had an opiate antagonist “implant” (unclear whether it is naltrexone or slow-release naloxone).
This is not surprising, and indeed clarifies the dynamics of events. The opioid antagonist is a type of drug that serves to prevent the effect of opiates but does not reduce cravings, it simply prevents opioid users from feeling the effect. Over time, a detachment from the use of opiates can occur, and even the desire to reduce it, but this rarely happens, because in 9 out of 10 cases the person stops taking naltrexone in order to be able to feel the opiate again. For this reason, more recently the “implant” has been invented, that is a kind of reservoir that is sufficient for a certain amount of time, so that for this period the person is “blocked” and cannot hear the opiates that one does.
Even in this case, however, the risks remain, and indeed can increase. Since the craving does not reduce immediately, and indeed can immediately undergo a surge, the person will try in every way to bypass the block of effects: one way can be to use mega-doses of opiates, another to combine opiates with other products that they amplify its effects, but which only work if the opiate acts, and not as long as it is blocked. For this reason, typically people on antagonists such as naltrexone tend to “fill up” with different substances, with the risk that as soon as an opioid manages to overcome the block, the effect appears in an explosive and uncontrollable way (overdose).
The cocktail would therefore have been composed of hydromorphone, pethidine (meperidine), hydrocodone (three opiates) taken recently, amplified by benzodiazepine-type tranquilizers, and combined with slow-release naloxone / naltrexone, which blocked the effect of all these. In addition, there was an antidepressant that shared some stimulant properties with pethidine.
The picture actually resembles that of an opiate addiction, which here were the drugs clearly sought out in an uncontrolled manner, as an implant had previously been made so that they could no longer feel them (which indicates that the person felt they had to resort to this. strattagema to avoid using them repeatedly and heavily) but then the same person searched for these drugs also combining them together, in an attempt to feel something. These more than others, since if it were to control pain, sleep, or anything else there are medicines that do not work with an opioid mechanism and therefore can be used without conflict problems with naloxone / naltrexone.
Cases like this in clinical practice are numerous, and the resulting overdoses are neither errors nor unpredictable facts, but they died of addiction, because the behavior that creates the deadly cocktail, or that exposes you to the risk of fatal effects, and just that of addiction. There are frequent cases of overdose among those who leave prison after being “detoxified”, or even from a clinic, or from a community where he has not used anything. Cases of overdose in these situations are even more likely than “on the street”, that is, in people who are regularly using abusive opioids, and result from the combination of a high desire, or that returns explosively upon exiting the free environment, the absence of a cure that protects from desire and therefore from overdose. L’
Clearly, therefore, it is not an error of use, but a use without control. Protective therapies are those based on agonists, i.e. methadone or buprenorphine, with which every drug addict should leave prisons, communities or clinics, at least to avoid this type of event, and then to seek complete control and rehabilitation WITH, and not WITHOUT, opioid therapy on her.
http://www.huffingtonpost.com/2009/06/27/michael-jacksons-supposed
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