Whitney Houston’s Death Refocuses Attention on Prescription Abuse

Proving culpability is difficult, experts said

Investigators issued subpoenas for records of Whitney Houston's medical prescriptions, apparently pursuing the possibility that prescription abuse was a factor in her sudden death Saturday while bathing.

Prescription bottles were found in Houston's room at the Beverly Hilton hotel, investigators said.  However, the Los Angeles Coroner's office has indicated it will not make the cause of death determination until toxicology labwork is complete, a rigorous task expected to take several weeks.

"Certainly in the Whitney Houston case, if it turns out that prescriptions were given that were inappropriate -- the wrong drugs in amounts that were improper, much too high -- then there should be some sort of investigation by the Medical Board or the DA," said Ellyn Garofalo, an attorney experienced in this area of the law.

But Garofalo cautions that, even if a causal link is made to Houston's medications, extending the culpability to her doctors or pharmacies would be far from automatic.

"The fact she is a celebrity who took drugs at one time isn't enough (on which) to base a criminal prosecution against a doctor or a pharmacy...There has to be more," Garofalo said.

Houston had acknowledged struggles with alcohol, cocaine and other substances, and had been admitted to rehab programs at least three times. But Garofalo said even an addict is entitled to medical prescriptions to treat an ailment or condition.

Prescription abuse became a priority of Gov. Jerry Brown during his tenure as Attorney General. 

After the overdose death of Anna Nicole Smith, the Attorney General's investigation led to criminal charges against three individuals, including Smtih's companion and two of her doctors, one of them represented at trial by Garofalo. He was acquitted.

Judge Robert Perry also threw out the jury's conviction of a second defendant, ruling it was not inappropriate for pain medication to be prescribed to Smith, despite her history.

But not all such prosecutions fall short. Last November, Doctor Conrad Murray was convicted of involuntary manslaughter for improperly administering medications that resulted in the death of his megastar patient Michael Jackson.

Doctors are expected to make a good faith effort to determine a patient's medical history, and if there are indications a medication is being abused, not to prescribe it. But Garofalo argued that it is unreasonable to expect doctors to act as police investigators.

When a doctor "writes a perfectly legitimate prescription--a 30 day supply of Xanax, for example--has to trust that his patient will follow the direction, and not go home and take all 30 days of Xanax in an hour," Garofalo said.

Another potential factor is interaction with alcohol. Many medications carry the warning: "Do not take with alcohol."

Houston had been drinking in the days before her death, according to witnesses. There are reports she had a beer and perhaps also champagne during her final room service meal before her bath.

To keep track of prescriptions, California's Department of Justice maintains a database known as "Cures."

Doctors have access, but Garofalo said it is cumbersome to use, and not practical for a doctor to consult each time before writing a prescription. What's more, Cures includes only prescriptions written in California.

Whitney Houston made her home in Georgia.  Which means even if an LA doctor had checked Cures before writing Houston a prescription, her prescriptions from home would not have shown up. 

"Where prescriptions are written out of state, the system is useless," Garofalo said.

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