SWALLOW Flashback Featured Post: What Really Killed Anna Nicole Smith?

"New York" Magazine (August 22, 1994)

What Really Killed Anna Nicole Smith?
by Maxim W. Furek, MA, CAC, ICADC
___________________________________

On February 8, 2007, the front desk staff at the Seminole Hard Rock Hotel and Casino in Hollywood, FL, made a desperate 911 call: “We need assistance to room 607 at the Hard Rock. It’s in reference to a white female. She’s not breathing and not responsive…actually, it’s Anna Nicole Smith.” Anna Nicole Smith was found lifeless in room 607 after bodyguard Maurice “Big Moe” Brighthaupt called the hotel front desk from Smith’s sixth floor room. Brighthaupt, a trained paramedic, administered CPR before Smith was rushed to Memorial Regional Hospital at 2:10 p.m. The TV reality star and former Playboy Playmate of the Year was pronounced DOA at 2:49 p.m. (CNN.com, 2007).

After a seven-week investigation, the official death report and autopsy were publicly released. The March 26, 2007, report acknowledged that Smith’s death was not due to homicide, suicide, or natural causes, but was caused by an accidental drug overdose.  During his press conference, Dr. Joshua Perper, Broward County Medical Examiner and Forensic Pathologist, stated that Smith died of “combined drug intoxication,” with the sleeping medication chloral hydrate being the “major component” in her death. No illegal drugs were identified but there were a total of seven prescription drugs, usually prescribed for anxiety, depression and insomnia, found in her bloodstream.  Smith, it was also revealed, had injected herself with shots of Vitamin B-12 (cyanocobalamin) and human growth hormone, as an anti-aging strategy. That brought the total number of substances in her bloodstream to nine.

Anna Nicole Smith had developed an increased tolerance to the sedative chloral hydrate and took more than the average prescribed doseage, according to Perper.  Smith ingested about three tablespoons, whereas the normal dosage is between one and two teaspoons. In his report Perper noted, “She may have taken the dosages she was accustomed to but succumbed because she was already weakened. Miss Smith has a long history of prescription drug abuse and has self-medicated in the past.”

CHLORAL HYDRATE
Synthesized in 1832, chloral hydrate was the first depressant developed for the specific purpose of inducing sleep. The infamous “Mickey Finn” or “knockout drops” consisted of a solution of alcohol and chloral hydrate that was popular in Victorian England and in that era’s literature.  When used properly, and without the introduction of alcohol or other depressants, chloral hydrate is effective in easing sleeplessness due to pain or insomnia. Unfortunately the effective dose and lethal dose of chloral hydrate are so close that the sedative should be considered dangerous (Avis,1990). Today, the use of chloral hydrate has declined as other agents, including barbiturates and benzodiazepines, have largely replaced them. In the death of Anna Nicole Smith, chloral hydrate became increasingly lethal when mixed with four prescription benzodiazepines: Klonopin (Clonazepam), Ativan (Lorazepam), Serax (Oxazepam), and Valium (Diazepam). In addition, Smith had taken Benadryl (Diphenhydramine) and Topamax (Toprimate), an anticonvulsant GABA agonist, which likely contributed to the tranquilizer effects of the chloral hydrate-benzodiazepine combination.

Although the individual levels of any of the benzodiazepines in her system would not have been sufficient to cause death, their combination with a high dose of chloral hydrate led to her fatal overdose. The autopsy report indicated that chloral hydrate was the “toxic/lethal” drug, but it is difficult to know if chloral hydrate ingestion would have killed her alone. And in a bizarre footnote to this tragedy, Chloral hydrate also contributed to the mysterious 1962 death of actress Marilyn Monroe, Smith’s idol (San Francisco Chronicle, 2007).

Despite rumors of methadone use (due to its involvement in her son’s death)  Dr. Perper stated that it was not a contributing factor. Perper only found methadone in Smith’s bile, indicating that the drug could only have been ingested 2-3 days prior to her death. Smith’s autopsy report indicated that abscesses of buttocks (presumably from prior injections of vitamin B-12 and human growth hormone), and viral enteritis were contributory causes of death (Sedensky, 2007).

On October 12, 2007 the Drug Enforcement Agency and California authorities served eight search warrants in connection with Smith’s death. Detectives collected over 100,000 computer images, files, patient profiles and other important documents associated with Smith’s death probe according to CA State Attorney General Jerry Brown. The investigation revealed that Dr. Khristine Eroshevotz, Smith’s personal psychiatrist, had written all eleven prescriptions. FOX News anchor Greta Van Susteren acquired paperwork from Perper’s office that indicated eight of the 11 drugs in Smith’s system, including the chloral hydrate, were prescribed to Howard K. Stern, not Smith. Additionally, two of the medicines were written for “Alex Katz” and one was written for “Dr. Khristine Eroshevitz.” Los Angeles physician Sandeep Kapoor, wrote out a methadone prescription using the pseudonym “Michelle Chase.” Eroshevich used the same pseudonym when she requested a variety of drugs to be couriered to the Bahamas to an “M. Chase.” The assortment of painkillers included two milliliter bottles of Lorazepam (Ativan); four bottles of two mg Dilaudid; two bottles of 350 mg Soma, containing 180 tablets; one bottle each of 30 mg Dalmane and 400 mg of the British drug Prexige; and one bottle of methadone, 300 5mg tablets (Friedman, 2007).

BARBIE DOLL
In a sense, Anna Nicole Smith had been able to transform herself into a real-life version of the Barbie doll. According to reports, Smith had breast augmentation that consisted of two implants placed into each breast. Over the last two years she also had a face lift and other cosmetic procedures (Furek, 2008). Moreover, it had been speculated that her dramatic weight loss, attributed to Trimspa X32, may have actually been due to gastric bypass surgery or a similar process (CNN.com/SHOWBIZ/TV, 2007).

It was impossible to have known the real Anna Nicole Smith. She said that she wanted to be “the next Marilyn Monroe” but had been known variously as Vickie Lynn Hogan, Vickie Lynn Marshall, Anna Nicole, Vickie Smith, Vicki Smith, Michelle Chase and M. Chase. Smith was only two-years old when her father, Donald Eugene Hogan,  deserted the family. Her life was a series of painful and tragic events, and it was against almost impossible odds that the platinum-blonde reality star climbed her way to the top of the celebrity world. Even with her success there were many who considered her a garish, ignorant and crude individual.  New York magazine featured a degrading photograph of Smith eating potato chips in its 1994 issue that was titled White Trash Nation. That same year Smith appeared in Naked Gun 33 1/3 and The Hudsucker Proxy and then filmed 2006’s Illegal Aliens. Her appearances were met with little media acclaim. The Anna Nicole Show was another pathetic attempt at entertainment, with Smith often dazed, confused and possibly in a drug-induced condition. That show stayed on the air for almost two seasons perhaps due to the morbid curiosity of viewers in anticipation of the star’s expected self-destruction. Much like Britney Spears, Anna Nicole Smith was unable to deal with her success. Both were creations of the celebrity machine with each providing us brief glimpses of hope and despair.

Three days after the birth of her daughter Dannielynn Marshall, Smith’s 20-year-old son, Daniel Wayne Smith, overdosed in his mother’s hospital room. Autopsy results revealed that he died from a drug combination of Zoloft, Lexapro and methadone. The tragedy of Anna Nicole Smith did not end there. On February 7, 2007,  a woman filed a lawsuit against Smith, who was a spokeswoman for the weight-loss supplement Trimspa X32. The lawsuit accused Smith of making “false and misleading” statements about the product. That event may have been the final blow to Smith’s  damaged and tortured psyche. The following afternoon, after ingesting a deadly combination of chloral hydrate and benzodiazepines, she drifted off into her final sleep. Smith was buried March 2, 2007 at Nassau’s Lakeview Memorial Gardens and Mausoleum in a plot adjacent to her son even as Virgie Arthur, Smith’s estranged mother, attempted to have her daughter’s remains exhumed and reburied in their home state of Texas. The merciless turmoil that defined much of Anna Nicole Smith’s life continued even after her unfortunate death.

_

Maxim W. Furek, MA, CAC, ICADC, is Director of Garden Walk Recovery, an organization “promoting wellness through drug prevention and education.” His i-Universe book, The Death Proclamation of Generation X: A Self Fulfilling Prophesy of Goth, Grunge and Heroin, was published in 2008. He can be reached at www.maximfurek.com
_

References:

Anna Nicole Smith died from accidental drug overdose: Ex-centerfold had been taking several potent medications. (2007). San Francisco Chronicle.

Avis, H. (1990). Drugs & Life. Dubuque, IA: William C. Brown Publishers.

California Attorney General: ‘Serious Evidence’ Uncovered in Anna Nicole Smith Death Probe. (2007). FoxNews.com.

Friedman, R. (2007). The Truth About Anna Nicole Smith’s Doctors. Foxnews.com.

Furek, M. (2008). The Death Proclamation of Generation X: A Self-Fulfilling Prophesy of Goth, Grunge and Heroin. i-Universe. ISBN: 978-0-595-46319-0

Reality TV star Anna Nicole Smith dies at 39. (2007). CNN.com.

Sedensky, M. (2007). Autopsy: Playmate died of accidental OD. The Associated Press.

Tags: alcohol, Anna Nicole, Anna Nicole Smith, anxiety, Ativan, Barbie doll, barbiturates, Benadryl, benzodiazepines, CA State Attorney General Jerry Brown, chloral hydrate, Clonazepam, cyanocobalamin, Dalmane, Daniel Wayne Smith, Dannielynn Marshall, depressant, depression, Diazepam, dilaudid, Diphenhydramine, Donald Eugene Hogan, Dr. Joshua Perper, Dr. Khristine Eroshevotz, drug intoxication, GABA, Garden Walk Recovery, human growth hormone, Illegal Aliens, illegal drugs, insomnia, Klonopin, knockout drops, Lexapro, Lorazepam, M. Chase, Marilyn Monroe, Maxim W. Furek, methadone, Michelle Chase, Mickey Finn, Naked Gun 33 1/3, pain, painkillers, Playboy Playmate, Prescription drug abuse, prescription drugs, Prexige, self-medicated, Serax, sleeplessness, SOMA, The Death Proclamation of Generation X, The Hudsucker Proxy, Topamax, Toprimate, tranquilizer, Trimspa X32, Valium, Vicki Smith, Vickie Lynn Hogan, Vickie Lynn Marshall, Vickie Smith, Vitamin B-12, White Trash Nation, www.maximfurek.com, zoloft