The High That Killed the King of Pop

Article excerpt

Byline: Sharon Begley

His doctor said it helped Michael Jackson sleep, but propofol is far more powerful.

When the 2009 autopsy report on Michael Jackson listed the cause of death as "acute propofol intoxication," his fans were not the only ones who wondered why he was being given this powerful intravenous anesthetic to sleep, as his physician--Conrad Murray, now on trial in Los Angeles for involuntary manslaughter--said. Propofol is not a sleeping aid; that's "not even in the ballpark of appropriate use," says anesthesiologist Beverly Philip of Brigham and Women's Hospital in Boston. But propofol has another property that experts are only beginning to focus on: it has a significant potential for recreational use and abuse. "It's not a narcotic like heroin, and doesn't get you high," says anesthesiologist Ethan Bryson of Mount Sinai Medical Center in New York. "But it does provide the feeling of oblivion or being spaced out ... And there is an association between having a history of sexual abuse and seeking the escape that propofol provides."

Jackson, who was acquitted of charges that he sexually abused a child, had said his father abused him physically and emotionally. "If you wanted to draw any inferences regarding Jackson's use of propofol and sexual abuse, it would be abuse that he suffered as a child and not perpetrated on another as an adult," says Bryson.

As a general anesthetic, propofol acts on the brain's GABA receptors, which cause inhibitory neurons--those that quiet other circuits--to fire; that's how it induces unconsciousness. Propofol also increases levels of the feel-good neurotransmitter dopamine, triggering a sense of reward not unlike sex or cocaine. Some patients experience euphoria, sexual disinhibition, and even hallucinations, followed by a feeling of calm and an upbeat mood. Since propofol is so widely used--it revolutionized ambulatory anesthesia, allowing a physician to knock someone out in seconds to perform, say, a colonoscopy, and have them up and about after only 10 minutes--scientists have had no shortage of subjects able to describe the experience. About one third don't remember a thing, and another third say they dreamed, but don't recall specifics. …