Severe insomnia tormented the King of Pop just weeks away from launching a series of 50 concerts in London to seal a comeback, revive his tarnished reputation and help lift him out of financial trouble.
While trying to put the agonizing condition to rest, the star found himself sucked into a vortex of prescription drug addiction facilitated by practitioners who provided him with a medicine cabinet full of Valium, the sedatives lorazepam and midazolam, and the dangerous anesthetic propofol, among others.
Jacksons personal doctor Conrad Murray, now in the crosshairs of an investigation into the stars death, stated that Jackson was very familiar with the drug (propofol) and referred to it as his 'milk, Los Angeles Police Department detective Orlando Martinez wrote in a warrant affidavit unsealed in Houston, Texas this week.
The chronology of Jacksons final hours reveals a 50-year-old whose musical talent, long the envy of millions, took a back seat to his final extravagant craving: to fall asleep in his home aided by a drug cocktail so potent that experts describe it as a potential killer.
There are no treatments for insomnia on Earth that include propofol, Drew Pinsky, an internist and addiction specialist, told AFP.
His problem wasnt the insomnia, it was his drug addiction, said Pinsky, who is also a Hollywood personality and host of the cable show Celebrity Rehab.
According to the affidavit, Murray admitted to police that in an effort to help rid Jackson of his insomnia, he administered the pop icon intravenous injections of 50 milligrams of propofol nightly during the six weeks prior to his June 25 death. But the cardiologist said he was concerned Jackson was becoming addicted, so on June 22, he halved Jacksons propofol dose to wean him off the drug and also administered lorazepam and midazolam.
The following night, he administered the latter two sedatives but withheld propofol, and the star was able to sleep. But throughout the next night, Jackson stayed awake.
At 1:30 am on the 25th, Murray gave Jackson a 10 milligram tab of the tranquilliser Valium. At 2:00 am, two milligrams of lorazepam.
At 3:00 am, he administered two milligrams of midazolam. Still no sleep. At 5:00 am, another dose of lorazepam, followed by more midazolam at 7:30 am, according the affidavit. Murray said that by this time, he was closely tracking the stars pulse with a monitor attached to his finger.
Jackson remained awake and at approximately 1040 hours, Murray finally administered 25 milligrams of propofol, diluted with lidocaine via IV drip to keep Jackson sedated, after repeated demands/requests from Jackson, the affidavit said.
Murray was monitoring Jackson closely, it stated, but then stepped away from his bedside to use the bathroom. When he returned two minutes later, Jackson had stopped breathing. His attempts to revive him were unsuccessful and the singer was declared dead at 2:00 pm.
Jeffrey Lieberman, chairman of the psychiatry department at Columbia University Medical Centre, said Jackson showed the classic pattern of a drug abuser who sought out a stronger arsenal of drugs to overcome his bodys heightened tolerance to medication.
The risk in increasing the dose or adding new, more potent medications of anything that is sedating is always overdose, and specifically some type of respiratory arrest, Lieberman said.
You get so sedated that your central nervous system is not able to maintain basic vital functions.
Lieberman said he would have never prescribed such an array of drugs.
This is something that is beyond what most reasonable physicians would ever prescribe, to have these different medications to be given within that timeframe.
Alexandre Rocha Abreu, a professor of medicine at the University of Miami, agreed.
Propofol is not a drug to treat insomnia in any case whatsoever, Abreu said, adding that the extremely dangerous drug should only be administered in a hospital setting.
Investigators found eight bottles of propofol in Jacksons mansion among other sedatives prescribed by Murray, dermatologist Arnold Klein and doctor Allan Metzger.
Several medical and legal experts have said they expect criminal charges including homicide to be brought in the case of the tragic death that shocked the world. What Dr Murray did, Pinsky said, was negligent.