Heath Ledger's death ruled accidental overdose

So freakin' sad. Looks like he was just trying to find some peace.

http://cityroom.blogs.nytimes.com/2008/02/06/heath-ledgers-death-is-ruled-an-accident/index.html

Heath Ledger’s Death Is Ruled an Accident
By Sewell Chan

The New York City chief medical examiner’s office has ruled that the actor Heath Ledger, whose body was found in a SoHo apartment on Jan. 22, died of an accidental overdose of prescription medications that included painkillers, sleeping pills and anti-anxiety drugs.

“Mr. Heath Ledger died as the result of acute intoxication by the combined effects of oxycodone, hydrocodone, diazepam, temazepam, alprazolam, and doxylamine,” Ellen Borakove, a spokeswoman for the chief medical examiner, Dr. Charles S. Hirsch, said in a brief statement on Wednesday morning. “We have concluded that the manner of death is accident, resulting from the abuse of prescription medications.”

The six drugs found in Mr. Ledger’s system included two painkillers: Oxycodone, the active ingredient in the prescription drug OxyContin, and hydrocodone, which is often combined with acetaminophen, as in the prescription drug Vicodin.

Also in Mr. Ledger’s system were three anti-anxiety medications, known as benzodiazepines, that are used to treat anxiety disorders and panic attacks by decreasing abnormal excitement in the brain: diazepam, sold under the commercial name Valium, which is used relieve anxiety, muscle spasms and seizures and to control agitation caused by alcohol withdrawal; alprazolam, commonly known under the brand name Xanax;and Temazepam, brand name Restoril, which is more commonly prescribed as a sleep aid than as an anti-anxiety medication.

One non-prescription drug was found in Mr. Ledger’s system: doxylamine, which is found in common nighttime sleep aids.

[. . .]

Dr. Vatsal G. Thakkar, a psychiatrist at N.Y.U. Medical Center and a clinical assistant professor at the N.Y.U. School of Medicine, said in a statement, “Six different sedative drugs in Heath Ledger’s system show something was amiss. Whether that was in taking combinations of drugs without proper medical guidance or sloppy prescribing, it was an unfortunate situation and with a tragic outcome.”

In a phone interview, Dr. Thakkar added, “Drug combinations are done and can be done safely, to an extent. In this situation, we have two painkillers, three anti-anxiety medications, at least one sleep aid. To have this many medications overlapping — different mechanisms, different compounds – I do not see an appropriate clinical situation where this should be acceptable.” It is not known how Mr. Ledger obtained the medications.

Dr. Andrew J. Kolodny, the vice chairman of psychiatry at Maimonides Medical Center and an authority on deaths by accidental overdose, said that combining anti-anxiety medications with painkillers can be particularly lethal. Both types of medications can lead to addiction, he said, making it more challenging for someone using the two types of drugs to avoid combining them.