Entries in Dr. Conrad Murray (2)


Murray Trial: Jackson Suffered from Demerol Withdrawal, Lawyers Argue

PRNewsFoto(LOS ANGELES) -- Lawyers for Dr. Conrad Murray said in opening arguments this week that he was trying to wean Michael Jackson off propofol, the powerful sedative the defense says Jackson gave himself the night he died.

They allege Jackson wanted propofol because he was suffering from insomnia brought on by withdrawal from the painkiller Demerol.

Murray's attorneys plan to call an addiction specialist, Dr. Robert Waldman, co-medical director of the Recovery Unit at Daniel Freeman Marina Hospital in Marina del Rey, Calif., to testify about the singer's addiction.

"And what he's going to tell you is that Michael Jackson was suffering from the Demerol withdrawal, that his insomnia was as a result -- partly, at least as a result," attorney Ed Chernoff said during the opening statement. Chernoff also told the court Jackson received Demerol three to four times a week from a dermatologist, Dr. Arnold Klein, but Murray knew nothing about these regular doses of Demerol. Klein didn't respond to ABC News' request for comment on the defense's allegations.

Jackson told Murray his insomnia was caused by his creative mind always racing, but it was also the Demerol, Chernoff said.

Medical experts say there are numerous symptoms associated with Demerol withdrawal, and insomnia is one of them.

"Withdrawal is very much like suffering from the flu. You can get nausea, diarrhea, vomiting, chills, tremors, a nervous or anxious feeling and insomnia," said Dr. Michael Schmitz, professor of anesthesiology at the University of Arkansas for Medical Sciences/College of Medicine.

Chronic use of Demerol generally causes sleepiness, but not everyone experiences that effect.

"There is a sub-population that reports insomnia," said Dr. Keith Candiotti, professor of anesthesiology and internal medicine at the University of Miami Miller School of Medicine. "Probably people who are chronically on drugs would be less susceptible to sedation."

Some experts say there are a number of medications that help alleviate withdrawal symptoms, including propofol, although others argue propofol should never be used for that reason.

"Propofol and benzodiazepines have been used for managing withdrawal, but primarily in intensive care units," said Schmitz. "That's not something that would have been done at home." Benzodiazepines are medications that treat conditions such as anxiety and insomnia.

"Propofol is an intravenous anesthetic, not to be used to treat Michael Jackson's addiction to Demerol or the withdrawal he may have had," said Bruce Goldberger, professor and director of toxicology at the University of Florida in Gainesville.

Murray told police he gave Jackson only a small dose of propofol, but the defense said Jackson administered the fatal dose himself. Chernoff also said that Murray felt it was his duty to wean Jackson off the propofol and teach him to sleep naturally.

Criminal defense attorney Mark Geragos, who is not involved in Murray's trial, said Chernoff's Demerol argument is central to the defense.

"I think it's essential," Geragos said. "My interpretation of his arguments is that Jackson may have become increasingly anxious to fall asleep." His growing restlessness, Geragos added, could have led him to self-medicate.

Copyright 2011 ABC News Radio


Michael Jackson's Death: What Is Propofol?

ABC News(LOS ANGELES) -- The trial of Conrad Murray, the doctor accused of giving Michael Jackson a lethal dose of propofol, has landed the powerful sedative in the spotlight.

Jackson reportedly used the drug, which he called his "milk," as a sleep aid. Murray administered the drug the day Jackson died.

But defense lawyers are expected to argue that Jackson gave himself an extra dose of propofol when Murray left the room. A trace amount of the drug, typically injected intravenously, was found in the King of Pop's stomach.

What Is Propofol? 
Propofol is a sedative that is usually administered to patients who are undergoing surgery or another medical procedure. It is a fast-acting drug, with most patients receiving it losing consciousness within a matter of seconds.

The potency of propofol as an anesthetic is so widely known that in anesthesiology circles, the drug, a white liquid, is nicknamed "milk of amnesia."

While propofol is most often used to sedate patients before a medical procedure, it is also one that palliative care workers have been known to administer to terminal patients who are in pain or who have weeks or days to live.

What Are the Dangers of Propofol?  Propofol is widely known as a risky drug, and it is generally administered only in a controlled medical setting due to the dangers it poses.

"Propofol is an agent that requires very close monitoring and is often limited only to use by anesthesiologists," said Dr. Richard Page, head of cardiology at the University of Washington Medical Center. "The main issue with this agent is respiratory depression, which in turn could cause cardiac arrest."

"It is a very dangerous drug," said Dr. Brian Olshansky, a cardiologist at the University of Iowa who said he often uses the drug to place patients in deep sedation for certain heart procedures. "It is not for sleep. I cannot imagine anyone would use this outside a very regulated environment such as the availability of emergency respiratory equipment."

One main reason for this, he said, is the speed with which the drug has its effect.

"It rapidly induces unconsciousness and apnea," Olshansky said. "People stop breathing within seconds of being given the drug."

Why Would Anyone Abuse Propofol?  The rapid effect of the drug makes it an exceedingly unusual choice for abuse, said Dr. Jeff Guy of Vanderbilt University, who said such a situation would represent "a quantum leap in the issue of substance abuse."

But despite the effects and risk profile of the drug, some patients who've had the drug describe it as inducing "a very pleasant sleep" that "has the potential to be habit-forming," said Dr. Howard Nearman, chairman of the anesthesiology department at University Hospitals Case Medical Center in Cleveland.

And Dr. Bruce Goldberger, chief of forensic pathology at the University of Florida, noted that the drug "also acts as an aphrodisiac in men -- it has been reported that men have very vivid sexual dreams while under propofol anesthesia."

Copyright 2011 ABC News Radio

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