Jackson, 50, was pronounced dead at the L.A. Medical Center Thursday after paramedics responded to a 9-1-1 call from his home and found him unresponsive.
The investigation into Jackson's death almost immediately began to focus on the medical treatment that he was receiving. Apparently, he was being treated by a doctor - a cardiologist with offices in Texas, Nevada and California - who lived at Jackson's seven-bedroom home as his personal physician.
Prescription Drug Overdose?
Adding to the speculation about a possible drug overdose, police impounded the car the doctor was driving because "there might be medication still in the car that would be helpful to the investigation."
Members of Jackson's family told reporters that the doctor gave Jackson a shot of Demerol shortly before he died. A family attorney told the media that he had expressed concerns about Jackson's use of pain medications and worried that he would one day "wake up dead" from an overdose.
A Combination of Drugs?
Rarely does a prescription drug overdose occur from taking too much of a single drug alone, although it can happen. The vast majority of drug overdose deaths happen because of a combination of drugs. According to the Drug Abuse Warning Network (DAWN) victims of drug overdoses have an average of 2.7 drugs in their system at the time.
Most prescription drug overdoses happen because the person takes more than one pain medication, or takes pain killers along with tranquilizers or sleeping pills, or drinks alcohol with pain killers, tranquilizers or other depressants.
Many times it's accidental. With pain medications, for example, the person may build up a tolerance to them so that they no longer provide the relief they need. So they begin to take larger doses or more than one kind to try to relieve their pain. The drugs begin to build up in their system with tragic results.
Respiratory Failure Causes Death
Opioid based pain killers like Demerol (meperidine), morphine and others cause death by suppressing the body's impulse to breathe. This causes breathing to slow and eventually stop, the same way an overdose of heroin will cause death. Death is usually due to respiratory failure, not cardiac arrest.
If any of this sounds familiar, two years ago former Playboy model and actress Anna Nicole Smith died as a result of having multiple drugs in her system at the same time. According to the official autopsy report, Smith had nine different prescription drugs in her body at the time of her death.
Naloxone Is an Overdose Antidote
If it was an overdose of Demerol alone that caused Michael Jackson to go into respiratory failure, he could have been saved with a treatment of naloxone, a medication that acts instantly as an antidote for any opioid overdose.
According to About.com First Aid Guide Rod Brouhard, himself a California paramedic, the paramedics who responded to Jackson's house would have had naloxone with them.
"Naloxone is in the basic scope of practice for paramedics in California," Brouhard said. "We all carry it. Heroin overdoses are some of the most common conditions we treat."
If naloxone was administered and it did not revive Jackson, that could indicate that his death, if it was a drug overdose, was the result of a combination of pain killers and other drugs.