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The death of pop icon Michael Jackson last week and the ensuing speculation a long-time addiction to narcotic painkillers caused his sudden cardiac arrest is shining a spotlight on the ongoing problem of physicians over-prescribing drugs to celebrities.

Jackson died last Thursday at his rented Los Angeles home at the age of 50 as he was preparing for a series of comeback concerts in London that were scheduled to begin this summer.

Jackson admitted in 1993 that he developed a painkiller addiction after fireworks special effects exploded and burned his scalp while filming a Pepsi commercial in 1984.

Comments from friends and associates suggest the singer struggled with that addiction right up until his death.

Spiritual adviser and medical doctor Deepak Chopra, who has been friends with Jackson for many years, said this weekend that the pop star secured a supply of narcotics from a number of physicians.

Chopra's suspicions that Jackson was addicted to painkillers arose in 2005, when the singer asked him for drugs.

Chopra refused, but later learned Jackson was, "able to find enabling physicians who co-operated with him," he told Â鶹´«Ã½ Channel on Saturday. "That's something that people who are addicted are very good at."

Initial reports had suggested that Jackson's personal physician, Dr. Conrad Murray, injected the singer with Demerol about an hour before he stopped breathing.

However, Murray's lawyer, Edward Chernoff, told The Associated Press on Sunday that his client did not prescribe Demerol or OxyContin to the singer, "not ever, not that day."

Drugs in Hollywood

If it is determined that an addiction to prescription medication led to Jackson's demise, the case will mirror those of a number of celebrities, such as Elvis Presley and Anna Nicole Smith, who died young and under the influence of a cocktail of narcotics.

In Presley's case, his personal physician, Dr. George Nichopoulos, prescribed him a number of narcotic painkillers and tranquilizers that likely contributed to his death from cardiac arrhythmia in 1977.

Nichopoulos, known as "Dr. Nick," was acquitted of criminal charges related to Presley's death. However, he was charged with gross malpractice by the Tennessee Medical Board for the illegal prescription of painkillers and other drugs to Presley, singer Jerry Lee Lewis and other patients.

In January 1980 he was found guilty of over-prescription, received three years' probation and had his medical licence suspended for three months.

Despite being acquitted later that year on other over-prescription charges, new charges in 1992 resulted in him being stripped of his medical licence in 1995.

In the case of former stripper-turned-reality television star Smith, three people have been charged in connection with the over-prescribing of medications: psychiatrist Dr. Khristine Eroshevich, lawyer and former boyfriend Howard K. Stern and Dr. Sandeep Kapoor.

The three are charged with allegedly conspiring to prescribe Smith an excessive amount of drugs, including methadone and clonazepam, using fake names.

A preliminary hearing to determine if prosecutors have enough evidence to take the case to trial has been scheduled for Aug. 12.

Smith died in February 2007 of an accidental drug overdose.

Painkiller addiction widespread

While there are a number of cases of celebrities falling victim to prescription drug addiction, it's a problem that extends far beyond the gilded gates of the Hollywood Hills.

"The number one cause of drug addiction in the world, particularly in America, is not street drugs but medically prescribed prescriptions," Chopra said. "It's a huge problem that needs to be addressed from within the medical establishment."

Figures from the United States Drug Enforcement Administration (DEA) reveal that accidental lethal overdoses involving prescription opioids (which include Percocet, morphine and Demerol) increased 117 per cent between 2001 and 2005, the most recent year data is available.

The data, which is found in the DEA's National Drug Threat Assessment (NPDTA), indicate that pain relievers are the most widely abused opioid, more than sedatives and tranquilizers combined.

And the number of people admitted to treatment facilities for prescription opioid addiction increased 74 per cent between 2002 and 2006.

While many of these patients may have originally been prescribed these drugs to treat legitimate health problems, the addiction can result when physicians fail to monitor their patients.

In Jackson's case, he was likely first given prescription painkillers to ease the discomfort of his 1984 injuries, and later to treat autoimmune disorders vitiligo, which he blamed for his lightening skin colour, and lupus.

Jackson's biographer, J. Randy Taraborrelli, told the New York Times last week that Jackson also appeared to be heavily medicated during his 2005 trial on child molestation charges.

"This is also another controversial issue amongst addictionologists and physicians, that how do you justify narcotics for pain because many times you don't know what the cause of the pain is," Chopra said. "Is it physical, is it emotional? Do you have a just reason for giving this? People decide amongst themselves. But even if you're giving the stuff, it has to be monitored very carefully, and obviously it wasn't in (Jackson's) case."

Indeed, Grace Rwaramba, who worked as an assistant and a nanny in the Jackson household for 17 years, told the U.K.'s The Sunday Times that she had to pump the singer's stomach on numerous occasions after he overdosed on what she called a mixture of drugs.

"I had to pump his stomach many times . . . He always mixed so much of it. There was one period that it was so bad that I didn't let the children see him."

Initial autopsy results could not determine Jackson's cause of death, so the Los Angeles County coroner has ordered toxicology tests that could take four to six weeks to complete.

Los Angeles Police Department officials have also interviewed Murray, Jackson's physician, and seized the car he drove to Jackson's home the day he died.

If it is proven that Jackson's death was the result of an overdose of prescription painkillers, the question that will remain is how.

Jackson recently passed a medical exam that was required to insure the series of 50 comeback concerts, which may have just been another source of pressure on the star.

"Premature death is always a tragedy, particularly preventable premature death. So it speaks to, I imagine, the lifestyle, it speaks to the immense pressure that many of these performers are put on," CTV's medical expert Dr. Marla Shapiro said Saturday on Â鶹´«Ã½ Channel.

"This was a man that was known absolutely everywhere. It's very difficult to imagine what it's like to live in that type of fishbowl world of extreme pressure and what that type of stress leads us to do in an effort to cope."