Heath Ledger died from an accidental overdose of six drugs - painkillers and sedatives - the medical examiner said Wednesday, leading doctors to warn of the dangers of mixing prescription drugs.
The 28-year-old actor died of "acute intoxication" from a combination of two strong painkillers, two anti-anxiety medicines and two sleeping aids, the medical examiner's office said. The drugs were oxycodone, hydrocodone, diazepam, temazepam, alprazolam and doxylamine.
Oxycodone is a painkiller marketed as OxyContin and used in other painkillers such as Percodan and Percocet. Hydrocodone is used in several painkillers, including Vicodin. Diazepam and alprazolam are the generic names for anti-anxiety drugs Valium and Xanax. The other two drugs are sleep aids commonly sold under the brands Restoril and Unisom.
The medical examiner and police wouldn't identify the medications Ledger had in his apartment when his body was discovered Jan. 22, nor would they discuss who had prescribed them.
The Drug Enforcement Administration is investigating how Ledger obtained the medications and whether they were prescribed illegally. That's common when so many drugs are involved in an overdose death, spokesman Rusty Payne said.
In a statement, the actor's father, Kim, said: "While no medications were taken in excess, we learned today the combination of doctor-prescribed drugs proved lethal for our boy. Heath's accidental death serves as a caution to the hidden dangers of combining prescription medication, even at low dosage."
Doctors not connected with the case said it would be unlikely for one doctor to prescribe all the drugs. However, they said it is not unusual for people to be prescribed painkillers and sedatives, and overdoses are common.
"This is not rock-star-wretched excess," said Cindy Kuhn, a pharmacology professor at Duke University. "This is a situation that could happen to plenty of people with prescriptions for these kind of drugs."
The medical examiner's office wouldn't say what concentrations of each drug were found in Ledger's blood. Experts said Ledger probably had been prescribed the medicine by a number of doctors, because several were from the same class of drugs and used to treat similar symptoms.
Ledger, an Oscar nominee for Brokeback Mountain, had said in a November interview that his roles in the Batman movie The Dark Knight (he plays the Joker in the summer release) and the Bob Dylan biopic I'm Not There had taken a toll. He said he had had trouble sleeping and had taken Ambien, which hadn't helped much.
The Ledger family returned to Perth, Australia, on Tuesday, and plans a private funeral service on Saturday. His former girlfriend and Brokeback Mountain co-star Michelle Williams and their 2-year-old daughter Matilda will also be there, according to People magazine