Done Too Soon

Both were irrefutably iconic figures. Both found success while still teenagers: Carrie Fisher appeared in her first film at 17 – at 19 she was Princess Leia; and George Michael signed his first record deal at 18. Both would be instant (if unconventional) stars, advocates for uncomfortable causes, and famously open about their struggles with drug use.

But did drug abuse ultimately kill them?

Losing Heart to Drugs

Both stars admitted to the chronic use of opiates and cocaine, drugs associated with damaging the heart and other vital organs. Both stars deaths were likely the result of heart problems – Fisher, 60, died after suffering a massive heart attack on a commercial flight, and Michael, 53, died of heart failure in his sleep.

What risks could these drugs have posed to their untimely deaths?

Cocaine: Studies into the long-term damaging effects of cocaine have found that it can cause inflammation of the heart muscle, deteriorate the ability of the heart to contract, and cause aortic ruptures.1 Cocaine stiffens arteries and thickens the walls of the heart muscle, these changes can lead to angina (chest pain), myocardial infarction (heart attacks), cardiac arrhythmia (irregular rhythms), cardiomyopathy (heart muscle dysfunction), myocarditis (heart muscle inflammation), and endocarditis (infection of the heart valve). It can also keep the blood pressure raised even after the drug is no longer used. It’s for these reasons the American Heart Association has called cocaine the “perfect heart-attack drug.”2

Opiates: Both heroin and opioids can have damaging effects on heart tissue. Heroin, often due to the drug’s adulterants and the unsanitary conditions in which users self-administer, can suffer infections to the lining and valves of the heart. OxyContin, the best-selling opioid in history, has been shown to damage heart tissue, even when taken orally. Then there’s the coating: Pills like OxyContin are coated. When crushed for injecting, the coating – which is essentially particles of glue – can cause blockages in the veins and arteries. Blood can pool up behind these blockages and infect blood vessels. These infections can be highly dangerous when they move to the heart and lungs.

Their Shared History of Drug Abuse

So far, any speculation on the true causes of death for either star can only be that – speculation. As of this writing: The official findings of George Michael’s autopsy were inconclusive and further testing will be needed; Carrie Fisher’s coroner case has been placed on security hold. In both cases the causes of their death were “not obvious.”

Michael admitted to abusing drugs at the time of his arrest in 2010. He would be charged with “driving while unfit through drinking or drugs” after driving his car into a storefront. As a consequence, Michael would spend four months in jail – and receive a five-year driving. (It’s believed the Michael had mixed narcotics and alcohol over the years and had been found passed out while driving repeatedly.)

Michael credited the crash into the storefront for shaking him out of his denial. Following jail he would undergo a year’s rehab at the exclusive Kusnacht Practice in Switzerland. It was reported that Michael returned to rehab in 2013 but he would neither confirm nor deny this. Tabloids have reported claims that both Michael and Fisher were still using drugs up until their deaths. (In both cases the stories relied on one unnamed source.) Fisher has confessed to having “four or five” slips, or relapses, over the last 23 years.

Apart from any drugs she may or may not have been abusing, we know that Fisher was taking medications for bipolar disorder. Appropriate medications can include mood stabilizers, antipsychotics, and depending on the situation, calcium channel blockers, thyroid medication, and even benzodiazepines. She may have also been receiving treatment for depression and anxiety. Long-term use of such medications can also create damage to organs and organ failure. They can affect the liver, kidneys, stomach, and heart.

Another side effect such medications can cause: Weight gain.

Weight and the Heart

Both stars were also known to have struggled with their weight. Carrie Fisher admitted to have gained weight in recent years. For her appearance in Star Wars: The Force Awakens Fisher lost 35 pounds. (She would famously joke that “They don’t want to hire all of me – only about three-quarters.”) It was reported, based entirely on some very dark and grainy photos, that George Michael had gained substantial weight recently. Both of these actions, significant weight gain and sudden weight loss, can put stress on the heart. With sudden weight loss, the heart can also lose some of its muscle mass. When the body isn’t getting energy from food, body tissue is used to convert glucose into energy.

The Stress of Bipolar Disorder

For Fisher and others suffering with bipolar disorder, there are often other risk factors for their health. In the cycles of mania and depression that accompany the condition there’s an added cardiovascular risk due to the stress that accompanies those symptoms. In fact, onset of cardiovascular disease occurs up to 17 years earlier among those with bipolar disorder than it does for the general population.3 Negative lifestyle behaviors can also complicate things: suboptimal nutrition, being sedentary, cigarette smoking, and the high likelihood of drug and alcohol abuse that are often common with the disorder.

Out of Nowhere?

One significant omission from the recent obituaries had to do with whether either star suffered from any prior health conditions. While it’s true both were entering age territory where heart problems are more of a risk, both seemed to be in reasonable good health. Neither was being treated for any ongoing conditions. While a healthy 60-year-old, like Fisher, should easily have many more years to live, the sudden death of a 53 year old, like Michael, is even more strange.

Otherwise, there are very few things that would cause a healthy person to die suddenly. What is more likely is they both had serious underlying health issues that led to their heart troubles. Heart failure is a progressive and slow condition. Victims will experience symptomatic shortness of breath, weakness, and swelling. They will feel arrhythmia, dangerous rhythms that can be expressed as pronounced racing or fluttering. If the arrhythmia is particularly abnormal, a defibrillator (ICD) may need to be implanted. Other symptoms can be progressive fatigue, cough and shortness of breath. Still, neither Fisher nor Michael spoke, publicly at least, of any heart-related conditions or ailments.

Of course, drug abuse can also be an instigating factor.

What Were the Chances?

A study conducted by the Drug Abuse Research Center at the University of California in 2000 found that young men who became addicted to narcotics could expect a reduction of life expectancy of 15 years compared to the general male population. More than just how drugs effect the body chemically – through chronic health problems, organ damage, etc. – there are also the risks associated with drug-seeking behavior.

The Centers for Disease Control also compiled statistics for the reductions in life expectancy and found that chronic use of the opiate heroin could reduce lives by more than half (52%). Each daily use of three injections will cost the user 68.4 hours of their life.4 A 2000 study by the Drug Abuse Research Center at the University of California found that young men who became addicted to narcotics could be expected to live to an average age of 46 compared to the average life expectancy of 61for the general male population. Another study found that an individual dying of an undetermined cause of death is 5.3 times more likely to have a history of drug abuse.5

For Carrie Fisher and George Michael, there was also this: People don’t just die without a reason. They’d either have an advanced illness, a fatal accident, a drug overdose, or something. For celebrities, very often the bitter truth of cause of death is often withheld as has been the case of the “security hold” for Fisher. (Although no reason was given, such a hold was also used for Whitney Houston, Paul Walker, and Robert Blake’s wife. Though it is unusual, it’s not unheard of.)

Even so, while it might be easy to blame drugs use, past or present, for contributing to their untimely deaths, for now, all we can do is speculate – and wait.

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Did Long-term Drug Use Kill Carrie Fisher and George Michael?