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KATHERINE JACKSON V AEG LIVE June 19th & 24th 2013

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BY MR. BOYLE:

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Dr Paul Early(Addiction Specialist)

By Video Deposition

Q. Dr. Earley, could you, please, state your full name and spell your last name for the record.

w.

A. My name is Paul Henry Earley, E-A-R-L-E-Y.

Q. And sir, are you a medical doctor?

ww

A. I am.

Q. And, sir, do you understand you have been hired by the corporation AEG Live and some of its executives and related
companies to testify here against Katherine Jackson and Michael Jackson's three children?

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Q. Hired by the law firm for the defendants?

A. My understanding is I was hired by the law firm, but that's the closest I can come to them, yes.

A. Yes.
Q. What are they called?

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A. O'Melveny and Myers.

Q. And how much are they paying you?

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A. For -- I'm not sure I know the exact dollar figure for each my of pieces. Around $300 an hour for research and $500
an hour for deposition.

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Q. And why do you want to testify against Ms. Kleindienst and Michael's three children?
A. I was asked for my legal opinion in the matter and it's of intellectual curiosity to me.
Q. When you say "legal opinion," are you an attorney?
A. I am sorry. My medical opinion. It was a mistake.

Q. So you're going to testify -- you are going to give your medical opinion today?

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A. I am.

Q. Against Mr. Jackson and the three children?

Q. Is that right?

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A. I am going to give my opinion as to certain matters regarded propofol and not for or against any particular position.
It's just my opinion, my medical opinion.
Q. Are you are working for money, correct?
A. Correct.

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Q. And your own intellectual curiosity, as you said?

A. Correct.

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Q. Sir, what type of doctor are you?

A. I am an addiction medicine specialist.

ww

Q. And what does that mean?

A. That means I care for individuals that suffer from substance abuse and related addiction disorders.

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Q. And, sir, what qualifies you to be an addiction medicine -- sir, what qualifies you to be an addiction medicine
specialist?

A. The addiction medicine is a field. When I entered, it had no specific qualifications, but over the past 28 years of
doing it, there has been a certification process and more recently a board certification process.

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Q. And, sir, are you board certified in addiction medicine?

A. I am.
Q. And when did you become board certified?

Q. Do you know what month in 2009 you were board certified?

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A. I do not.

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A. The first year that test was offered. And I think that was 2009 .

Q. And what specific training have you had in addiction medicine that allows you to be a specialist?

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A. Well, my initial training was in neurology. So I have extensive knowledge of brain pharmacology,
neuropharmacology, neurophysiology. And then since then, I have had training in psychotherapy, experiential
psychotherapy, and -- because there was no specific training when I started off. It was basically on-the-job training with
other addiction experts. And that's how -- initially how I learned that, and then took any kind of certification tests and
exams that were necessary over the years.
Q. And, sir, how many years in total would you say you have been working or training that have led you to become an
addiction medicine specialist?
A. Twenty-eight.

A. That's correct.

am

Q. And, sir, I have viewed -- I have seen everything on your website and all of your articles. And you have done a lot of
interviews and written a lot of articles on the subject, correct?

Te

Q. And all very impressive. And you consider yourself an expert in that, correct?

w.

A. I consider myself an expert in most areas of addiction medicine. There are some areas that I know less about, but in
general, yes.
Q. Sir, are you qualified to treat patients who have addiction?

ww

A. I am.

Q. And what has -- are you qualified to treat patients who have dependency on chemicals?

A. Absolutely.

A. Yes.
Q. And what gives you that qualification?

A. I am.
Q. And what gives you that qualification?

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Q. And, sir, are you qualified to treat patients who are addicted to propofol?

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A. My ASAM certification and 28 years experience and also a teacher in the field.

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Q. Now, sir, are you qualified to treat patients who are addicted to opioids?

A. Because I have treated more propofol dependent people than probably any single clinician in the United States.

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Q. And, also, your 28 years of experience in the field?

A. Correct.

Q. And your board certification as an addiction medicine specialist?

A. Correct.

A. It is.

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Q. And, sir, are you qualified -- strike that. Is Demerol an opioid?

Q. Sir, are you qualified to treat patients who are addicted to or dependent on Demerol?
A. Yes.

Q. And what gives you that qualification?

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A. The same as the previous.

Q. Twenty-eight years experience, board certification, personal experience treating them -A. Yes.

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Q. -- is that correct?
A. Uh-huh.

Q. Is that a yes?

w.

A. That is a yes.

Q. And, sir, what a benzodiazepine?

ww

A. Benzodiazepine is a large class of drugs that are sedative drugs that are also used for sleep induction.
Q. And, sir, are you qualified to treat patients who are addicted to or dependent on benzodiazepines?

A. I am.

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Q. And what gives that you qualification?

A. The same process certification, experience, and being a teacher in the field.

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Q. Let's take propofol addiction or dependency. Do you think if a patient is going to be treated for propofol addiction or
dependency, do you think it's important that a qualified doctor treat them for that or is it okay if any old type of doctor
treats them for that?

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THE WITNESS: I think the qualification is a broad term and there are various ways to attain -- to become qualified, but
I believe some type of qualification is important when treating any type of illness.
BY MR. BOYLE:

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Q. And so, sir, you actually run a facility that treats addicted patients, correct?

A. Not at present. I have done that up until January of 2012 -- February of 2012. And now I am running what's called
a physician's health program in Georgia.
Q. What does that mean, "physician's health program"?

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A. What we do is monitor the -- what we do is help physicians who have addiction disorders get treatment, obtain good
treatment and monitor their long-term recovery from their chemical dependence disorder.
Q. So fair statement, what you are doing now is you are involved in the long-term overall monitoring of physicians who
are or have been treated for addiction or dependency?

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A. Correct.

Q. And before you did what you are doing now, you did run a treatment center?
A. For most of my career, yes.

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Q. And how many years did you run the treatment center?

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A. I have run three separate treatment centers during my career. And that has lasted 27 of my 28 years of working in
addiction.
Q. And let's take your last -- the last sort of entity that you were running that was an addiction treatment center. Okay?

ww

A. Good.

Q. What was that called?

A. It was called Talbott Recovery Campus.

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Q. Did you ever have any celebrities that were treated at -- without telling me who they are, any celebrities who were
treated at Talbott Recovery Services?
A. I did.

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Q. Did you ever have a situation where you turned away patients for treatment at Talbott Recovery Services and said no,
why don't you just go and see a cardiologist?

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A. If we had someone that had cardiovascular disease, we would refer them out to take care of the cardiovascular
disease, if that's what you are asking.

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Q. No, what I am asking is did you ever have someone come in and they said "I have an addiction, I have an addiction to
opioids," for example, and you said, "No, we're not going to treat you here at Talbott Recovery, you would be better
served just by going off and finding some random cardiologist." Did you ever do that?
A. We would never send a patient to a random doctor.

Q. Because such a doctor would not be a specialist in treating people with addiction, correct?
A. Actually, I was more aimed at the fact that we wouldn't send anyone to a random physician.

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Q. So in other words, you would check out whichever physician you were going to send them to, correct?
A. We would know of that physician's qualifications.
Q. What would you do to find out about that?

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A. Well, we would know about that physician's past history of work. We would know about their educational
background. We would know about their past skills. We would know about maybe past patients that they had treated.
Q. Would you do any -- make any effort to determine whether that doctor was financially desperate in any way in such a
way that they might make bad decisions?

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A. I don't think that would enter into our decisions.

Q. But you would at least find out what kind of doctor they were?
A. Yes, what kind of doctor and what their skill set was.

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Q. And, sir, fair statement that you are an advocate for helping people who have addiction, correct?
A. Absolutely.

ww

Q. Sir, have you ever heard the term "enabler"?

A. Yes, I have.

Q. What is an enabler?

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A. Well, that's -- again, that's a term that in the common lingua franca, the common language that refers to an individual
that instead of helping someone get better in out of what feels like kindness, actually is hurtful for their addiction.

A. That is correct.
Q. And what about the term "codependency"? Have you heard that?

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A. I have.

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Q. And so the term "enabler," does it come from the concept that they are actually while they think they're helping, they
are actually enabling the addiction?

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Q. What is codependency?

A. It's another term that has -- is not used in the addiction field anymore, but it's prevalent in the general -- in the general
world where people think of individuals that are so close to an individual, that they wind up not being able to figure out
how to best help the person that they love or they care for.

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Q. Sir, have you ever seen a situation where an addicted person was being enabled by another person who had something
to gain from that addicted person?
THE WITNESS: I guess I could construct a situation where that might occur, yeah.

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Q. Yeah, I mean I have been doing some research on, you know, enabling and codependency and I have read certain
things, like sometimes a person can be considered a codependent to an addict when they stay close to the addict because
they rely on that addict for some reason. And then they, therefore, become an enabler because they want to keep the
situation going. Do you know what I am talking about?
A. Yeah. I don't think that is actually an accurate description, but I hear that is how you see it. I think that is actually
what one would call secondary gain.

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Q. Explain that for me, secondary gain.

A. A secondary gain is where you are involved in a situation where you have -- the agenda is not to be helpful in getting
that person better but some other issue, such as you don't want your husband, who is a physician, to not be able to work.

w.

Q. So the sort of example you put at the end there, that could be a situation where a spouse of a physician wants that
physician to keep working and so enables that physician's addiction. Is that what you are talking about?

ww

A. Yeah, yeah, that's clear enough.

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Q. And then in terms of enablers, is it a fair statement that often enablers provide addicts with the means to be able to
continue their addiction, for example, with finances?
A. I guess I could construe a situation where that might occur, yes.

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Q. And, you know, I think this is -- and often enablers might want to be willfully blind to the addiction. Is that a fair
statement?

A. Most enablers are not willfully blind. Most enablers, their intent is to be benevolent and to be helpful, but they can't
see the problem because addiction is a disease of secrecy and confusion. So oftentimes, an enabler can't see it.

ck

Q. My question is based on what you reviewed, you knew that Dr. Murray was giving Michael Jackson medicine to feed
his addiction, correct?

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A. I don't agree with that. I think that what Dr. Murray doing was at the time what he felt was the best thing and helping
his sleep. Now, was this misguided? In retrospect, obviously, that seems to be the case.
Q. You are not telling the jury that you think that what Dr. Murray did was okay, are you?
A. I am not.

A. No.
Q. That was wrong, correct?

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Q. Was it okay for Dr. Murray to administer propofol to Michael Jackson in a home setting like he did?

A. That was medically incorrect.

Q. And would you ever do that?

Q. Why not?

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A. I would not.

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A. Well, that goes to my opinion. And my opinion about the matter of propofol is that home -- he did not have proper
monitoring for -- of his CO level or his breathing level or his oxygenation. He did not have proper rescue equipment
available for him. He was giving a medication which had a steep dose response curve, which makes it difficult to judge
the exact right dose. He gave that medication after giving him Lorazepam and Valium, Diazapam. And as a result, he
created synergy with the other drugs which placed him at risk. And he was using an intravenous introduction technique
which was nonstandard and which was prone to develop problems such as pulmonary emboli from clots from leg veins.
Q. And did you also see Dr. Murray's phone records on the day that Michael Jackson died?

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A. I did look at them. I can't describe them verbatim but I did look at them.
Q. Did you see he was on the phone a lot during the time he was purporting to be treating Michael Jackson?

A. I did.

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Q. Is that appropriate for a physician to do that?

A. Not -- it is not. And the reason it is not is because continuous monitoring is indicated, which places Michael Jackson
at high risk for -- for not surviving that technique.

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Q. And, sir, based on your review of the record, you understand that Dr. Murray is in prison for killing Michael Jackson,
correct?
THE WITNESS: Dr. Murray is in jail, to the best of my knowledge.

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A. Propofol is not an appropriate agent for sleep induction.

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Q. And you are of the opinion that nobody should be administering propofol just to get someone to sleep, correct?

Q. And nobody should be giving propofol to somebody just because that somebody might get some sense of euphoria
out of it, correct?
A. Propofol is not a drug which is -- no drugs are used in medicine for the production of euphoria.

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Q. Well, if someone had steered Michael Jackson your way in 2009 , do you believe you could have done a better job
treating any addiction he may have had?
A. Under the circumstances that were present at the time, I don't think I could have done a better job in terms of getting
him in recovery, if that's what your question is.

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Q. Is there any level of propofol that someone can be on where they can talk?

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A. Yes, you can -- this just goes to this issue of the steep dose response curve that I was talking about earlier, that yes,
you can be in that state but the change in the dose between being in a light twilight state and being completely obtundent
is very small and varies from time to time. And that means that individuals who are given propofol in an uncontrolled
environment are at higher risk for death if they are not properly monitored because that steep dose response curve, you are
never quite predict when an individual is going to be asleep -- twilight state, asleep or obtundent. And the doses can
actually vary from time to time.

w.

Q. So it sounds like administering propofol is a highly, highly technical matter.

ww

A. It's -- yeah, technical in some ways. When you have proper breathing apparatus around, you don't worry about
putting someone too deep because you can always assist in their breathing and you can always -- the other complication of
propofol is it also lowers blood pressure and you can also help the blood pressure with what are called pressor agents,
agents which will raise the blood pressure. So those two consequences could be easily maintained in an operative theater.

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Q. Sir, in your review of the record materials in this case, did you see anything that indicated that Dr. Murray had
oxygen tanks in the Carolwood house?

A. I believe he had oxygen tanks but not any sort of breathing mask or rescue -- what is called rescue equipment and
anesthesia.

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Q. So without the breathing mask, he would not keep the breathing going, correct?

A. Right. Because the breathing masks actually provide short-term CPR, if you will, in case you stop breathing.
Q. And is that a common mechanism of death in a propofol overdose?

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A. It is the -- stopping breathing can occur in several ways from propofol. One is because of the fact that the laryngeal
muscles become lax. And an individual such as Michael Jackson who has a large tongue can actually obstruct his
breathing apparatus. So that's why if he was being given propofol over a period of time, at any given time, he could
obstruct and he could have died, whoever was giving that propofol. And so that's one way of -- you couldn't tell the
difference between actually his breathing muscles stopping and the breathing functioning failing because the laryngeal
muscles relaxed. The tongue goes back and obstructs the upper airway.
Q. Now, in the administration of propofol in an appropriate setting, what is done about the tongue problem?

M
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A. Two things. There are actually three things. The majority of cases, there is either an airway available or they're
actually intubated where the breathing tube goes past the upper oral pharynx, the upper breathing area. So they bypass so
that it holds that area open. And the third thing one can do is breathe forcing one by applying positive pressure with an
ambu bag or similar apparatus.
Q. And none of these three things were done with regard to Michael Jackson, correct?
Q. At the time Mr. Jackson died, none of these three breathing assistance procedures were done, correct?

BY MR. BOYLE:

am

THE WITNESS: What I do remember from the record is Conrad Murray did perform CPR on him. So that is essentially
the same as an ambu bag. Whether that was too late or not is unclear.

Te

Q. But there was no -- there was nothing -- there wasn't another airway open, correct?
A. There was not another airway open.
Q. And what is that called when they call cut something in the throat?

w.

A. Tracheotomy.

Q. So there wasn't that done, correct?

ww

A. Correct.

Q. And there wasn't any intubation done, right?

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Q. But what was done when Dr. Murray saw something was going wrong, he tried CPR, correct?

A. Correct.

A. Correct.
THE WITNESS: To the best of my knowledge, that's what the records reflect.

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Q. Sir, in working in addiction medicine, I am assuming sometimes there is patients who need CPR, correct?
A. Correct.

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Q. Is it inappropriate in your field to give CPR on a soft bed as opposed to a harder surface? THE WITNESS: It's -- it's
certainly appropriate to put the individual on a hard surface for proper CPR.
BY MR. BOYLE:

A. In 2009 , he did have an addiction, yes.

Q. And what is the basis of that opinion?

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Q. And, sir, do you have an opinion as to whether Michael Jackson in 2009 was -- had an addiction?

A. Because of his -- are you asking about any specific drug or are you asking about generally any addiction?

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Q. Good question. Well, let me think about it now. Do you think he had addictions to more than one drug?
A. I think he clearly had an addiction to opioids, that class of drugs.
Q. Do you think he had an addiction to any other drugs?

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A. I don't think there is sufficient evidence to -- from the record reading to ascertain whether he was addicted to either
propofol or benzodiazepines. There are suggestions in the record but there is not sufficient information.
Q. With regard to opioids, what -- which drugs within the opioid class do you think Mr. Jackson was addicted to?

Te

A. The primary drug of his addiction was meperidine, the trade name Demerol. And that was by far and away the most
common opioid that he took. There were several cases where he was given other narcotics for pain relief and that sort
of thing and -- but the meperidine was the primary drug that he used in the opioid class.
Q. And that is -- more common term -- usage is Demerol?

w.

A. Uh-huh.

Q. Is that a yes? Sorry.

ww

A. Yet, it is. Yes, that's the trade name, is Demerol.

Q. Now, do you have an opinion with regard to whether Michael Jackson's death was caused by Demerol?

Q. Do you know if there was any Demerol in Michael Jackson's system after he died?

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A. Michael Jackson's death was not caused by Demerol directly. There is a question as to whether the Demerol
produces synergy and helped create the death from propofol and benzodiazepines.

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A. I don't remember the exact quantity, if there was. What I do know is -- but there are other issues involved with the
opioids and death, so.
Q. So we will get to that. Let me ask this way. Do you believe a Demerol overdose caused Mr. Jackson's death?

Q. Do you believe a benzodiazepine overdose caused his death?

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A. I do not.

A. Not benzodiazepines alone. Benzodiazepines in synergy with propofol were most likely causative in his death.

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Q. How long in time do you think Michael Jackson was addicted to these classes of drugs?

A. The opiod drugs, there is evidence of addiction to opiod drugs which dates back into the early 1990 's, going to
concerns about his long-term prognosis for recovery because the longer you are on an opiate, the worse your prognosis is
for recovery.

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Q. What about the propofol? I guess you don't -- you didn't determine whether he was addicted to propofol, right?
A. No, I didn't think there was sufficient data in the record for me to reach a conclusion -- a conclusive opinion about it.
Q. Now, on the evidence regarding Mr. Jackson being addicted to opiods back from the early 1990's, are you basing
that opinion in part on the deposition of Dr. Stuart Finkelstein?

am

A. Yes, that was one of the opinions that led me to that, yes.

Q. And did you read the deposition of Dr. Stuart Finkelstein?

A. I did.

Te

Q. And let's talk about opiod addiction. What are the ways that it can start?
A. Opiod dependence starts simply enough when people who are susceptible to addiction ingest opiods.

w.

Q. And what makes one susceptible to dependence?

ww

A. It's multi-factorial. The single largest contributor is genetics when you look at large populations. The single
strongest determinant is whether your parents had a substance abuse or dependence disorder, but that does not mean that
percent of people that develop addiction have genetics of addiction in their family. The other contributor -- contributing
factors are other psychological issues, early life trauma, access to drugs of abuse or alcohol in the case of alcohol abuse,
and access. I think that I said it, access.

Q. Hopefully.

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A. The problem that we have here is a man whose reputation and skill and wonderment exceeded probably, you know,
percent of the people on the planet. And I would like to say that I would never do that, but this was a very difficult and
different situation.

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Q. He was one of the most beloved entertainers in the world, correct?

A. Absolutely.
Q. And people wanted to be near him, correct?

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A. Correct.

Q. Now, and you would like to say you wouldn't have done what these doctor did, correct?

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A. I would like to say that.

Q. But if you did, if you gave in and you did it, that wouldn't be okay, would it?
A. It would not be okay.

Q. And to do what Dr. Murray did was simply not okay, correct?

BY MR. BOYLE:
Q. Correct.

M
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THE WITNESS: Which thing that he did? You mean the prescribing the propofol?

A. Prescribing the propofol ultimately resulted in Michael Jackson's death.

am

Q. Right. And that's not okay.

A. And that's not okay. And, sir, could you tell me more about withdrawal symptoms from propofol.
A. This is where the study -- where it says "Study" on my sheet.

Te

Q. Yes, sir.

w.

A. We, in our case study of propofol dependent individuals, we were able to characterize the withdrawal. And the
withdrawal is depression, insomnia and irritability. Those are the three hallmarking signs of withdrawal.

ww

Q. Sir, did you -- based on your review of the record, did you see any of these symptoms of propofol withdrawal in
Michael Jackson?
A. He -- Mr. Jackson most likely had some baseline insomnia, which was paradoxically worsened by the use of
benzodiazepines and propofol.

Q. So you believe that his insomnia -- with regard to propofol, his insomnia was worsened by the propofol use?

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A. Correct, yes.
Q. Or worsened by the -- or the withdrawal from propofol.

A. Yeah. I mean they're both the same. You get the drug, you are going to get the withdrawal at some point, yeah.

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Q. I guess my question is to make it real simple, when the propofol -- when you are given the propofol, are you out.

A. Right. So when you take away the propofol, you have the insomnia after the propofol is no longer administered.
Q. Got it. And, sir, what about chills. Is chill -- is chills a symptom of proposal use or withdrawal?

ck

A. We don't -- people can be irritable. We haven't actually seen chills. We have had individuals that have had seizures
associated with propofol withdrawal but not specifically chills.

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Q. Did you see in the record anywhere that Michael Jackson showed up for rehearsal shortly before he died and was
suffering extreme chills?
A. I did.

Q. Do you have an opinion on what that was all about?

M
ich

A. Chills is a very generic symptom and could mean anything from the flu to, you know, some other -- a cold, low
blood sugar. There is lots of different reasons why people have chills and it's a fairly nonspecific symptom.
Q. Now, sir, you're qualified in and an expert in getting people off drugs, correct?
A. Correct.

am

Q. And is it appropriate to take a person who is addicted to Demerol -- is it an appropriate practice to just cut them off
cold turkey?

Te

A. Discontinuing opiods cold turkey is not life threatening. It can be done and there are people that will do that. And
as a matter of fact, before we had certain detox drugs, that's what I would do, but it is not the current practice today now
that we have other medications to help detoxify opiod-dependent individuals.
Q. And what is the current practice today?

w.

A. Is to taper on a drug called buprenorphine.

Q. And, sir, are you familiar with the drug called suboxone?

ww

A. That is buprenorphine.
Q. And could you explain what that is.

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A. Suboxone is a drug which is -- contains buprenorphine as its primary ingredient. And then the secondary ingredient
is something called naloxone. And the reason -- do you want to know technically why it's a combination?
Q. Sure.

so
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A. The naloxone is placed in the suboxone so people who are chemically dependent or addicted can't take the suboxone
and grind it up and inject it because the naloxone, if injected, blocks the effects of the buprenorphine, but if you take it
orally, it's not absorbed. So you can have the buprenorphine detoxification without consequences, but it can't be
injected.

ck

Q. And, sir, did you see any evidence in the record that Mr. Jackson was treated by anyone with suboxone?

Q. Do you know when that was?

A. I don't. I don't remember the dates.

ae
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A. I saw evidence in the record that he was treated with buprenorphine earlier, but I think it was by Dr. Gordon, if I
remember correctly.

Q. Did you see any evidence in the record that Dr. Conrad Murray was treating Mr. Jackson with buprenorphine?
A. I did not.

M
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Q. Did -- and can we just call it suboxone because it's easier to say?
A. Absolutely.

Q. Does suboxone exist in 2009 ?

A. It did.

A. I was.

am

Q. And were you treating people with suboxone in 2009 ?

Q. What about propofol addiction, what is the proper way to treat propofol addiction to get somebody off the drug?

Te

A. This -- when people are addicted to propofol, you just stop it.
Q. And why is that?

ww

w.

A. Propofol is a short-acting drug. So discontinuing it is not life threatening. There are under the vast majority of
consequences -- actually, we have had several cases where we did have to give sedative drugs to keep patients from
seizing, but these are health care professionals who are taking huge quantities of proposal. Under normal
circumstances, you discontinue the propofol. And occasionally, you will give a sedative drug for several days because
the patients are agitated or irritable, but there's no other detoxification that is used.
Q. And what about benzodiazepine, what is the appropriate way to get somebody off of benzodiazepines?

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A. Benzodiazepines require a cautious, careful taper. Some individuals are very sensitive to benzodiazepines and it's a
very difficult drug to get off of. Despite the fact that they're medically safe, detoxification is difficult. So a slow,
tapered decrease over time is the way to do that.
Q. Was that the practice in 2009 ?
A. It was.

A. Yeah.
Q. That's what you have tried to get people offer of drugs, correct?

ck

A. I get people off of drugs, yes.

ae
lJa

Q. And do you that for their health, correct?

A. That is correct.

so
n

Q. But when I say get people cleaned up, I am talking about getting them off the drugs. Do you understand that?

Q. Because any other way would be not appropriate, correct?

A. I practice medicine based on the patient's health.
Q. You are not going to answer my question?

M
ich

A. I don't -- you know, I don't -- I don't make my medical decisions based upon a corporate decision. I make my
decisions based upon the health of my patients. So I can't answer the question like that because I base my decisions on
my relationship with my patient.
Q. And you're a good and ethical doctor, correct?

am

A. I would like to think I am.

Q. And all of those things that you just testified, that is something that Talbott Recovery would have tried to assist with
Mr. Jackson, correct?

w.

Te

A. The operative word in your question is "tried." The problem is several-fold. First of all, he was taking opiates for a
prolonged period of time, which decreases his prognosis. Two, is that he had this legendary status, which caused people,
unfortunately, to set aside proper boundaries and would cause someone to prescribe drugs for him. Three, he was
providing financial resources for a lot of his family so that it would render them impotent in being able to effectively
intervene on him. Four, he was extremely secretive in terms of his style. He cordoned off one physician from another.
He wouldn't talk about his drug use when asked about it from Physician B to Physician
A. And all of those things predict, tragically -- a huge tragedy -- predicted a very grave outcome.

ww

Q. If Michael Jackson had been sent to your recovery center, how would you have treated him?

so
n

.co

A. I would have at the front door asked if there -- tried to understand if the family could all stand behind him not
obtaining drugs and understand they have an addiction disorder. I would have told him at the front door that because his
addiction, through no fault of his own, was quite severe, that he needs a prolonged period of rehabilitation, multiple
months, probably, you know, more than three less, than a year in initial treatment. I would have told him that he needs
to be on naltrexone after treatment. I would have looked for alternative ways of managing his pain. I would have to
figure out how to close down his access to opiods from other sources, which would have been in his case a Herculean
task, contacting every single doctor, you know, having us contact every pharmacy, closing down all the prescriptions at
all of his pharmacies. I would have given him a series of skills that are called drug-refusal skills around opiods. And I
would have worked to unearth the tragic secrecy that was surrounding all of his drug use, which unfortunately,
contributed to his terrible death.

ck

Q. Now, the first thing you said is try to understand if his family would stand behind him, you know, to make sure he
doesn't get drugs, right?
A. Uh-huh.

ae
lJa

Q. Is that correct?
A. Uh-huh.
Q. Is that a yes?
A. That is yes.

Q. But you are not saying you have any information that his family was getting him drugs, are you?

M
ich

A. No, there is no evidence -- I have -- I am completely clear that his family wanted nothing but the best for him.
Q. And, in fact, you read in the records that his family tried to do interventions for him, right?
A. Yes. And one intervention failed because they came to see him and he appeared quite healthy. And so the
intervention was defused at that point, which is sad but true.

am

Q. But you have no information that the family didn't do the best job they could do to try to do what they could do,
right?

w.

Te

A. Correct. The problem comes from the fact that it comes from this issue of power. That is why it's much more
difficult, for instance, to treat the patriarch of a family versus the patriarch's grandson -- does that make sense -- that if
the power in the family -- in the power in the family emanates -- and in our society, a lot of that power comes from, you
know, supporting people financially -- it's very hard for a family member to get past that. So we would have to had to do
an enormous amount of work to get past the natural resistance to give into his requests. And I am not -- I want to be
clear that I am not -- that by saying that, I am not inferring that the family was in any manner, shape or form getting
drugs for him or helping support his addiction, but -Q. Because there is no evidence of that, right?

ww

A. I think there is zero evidence of that. They loved him and they wanted him better.

.co

Q. And, sir, you are aware also at the time Michael Jackson died, his immediate family consisted of himself and three
young children, correct?
A. Correct.
Q. And then his elderly mother, who he supported, correct?

so
n

A. Correct.

Q. And you don't think that three young children or his elderly mother were getting him drugs, correct?
A. I absolutely don't. I have no thoughts of that.

A. Correct.

ae
lJa

ck

Q. And, sir, then you said the second thing was, you know, you would let him know that his addiction was serious
through no fault of his own, correct?

Q. And so you don't believe that Michael Jackson's addiction was his fault, correct?

A. No. Addiction is a biologic disease that once it gets going, overrides a lot of the things
decisions in life.

M
ich

Q. And so it's not the addict's fault, correct?

that allow us to make good

A. Correct.

Q. And so if somebody were trying to point the finger at Michael Jackson and saying his death is all his own fault,
would you agree with that?

Te

am

THE WITNESS: I have dedicated my career to taking care of the addicted people in this planet. Okay? And so it's
important for you to know that I would stand strongly against anyone that would blame the addict for their problem.
That doesn't mean, however, that the addict has to at some point take responsibility for their recovery. And that doesn't
occur right away. Sometimes it takes months, sometimes it takes -- and that's really why treatment takes so long. So no,
I don't believe it's proper to blame the addict. Most people that are addicted, tragically, in our society especially, blame
themselves -- not try, by the way, in European cultures. But they blame themselves. They have shame about their
illness. They develop secrecy. And that's exactly what we saw in this case. It's secrecy hiding -- protecting -- having
one doctor not talk to another lest one find out the Demerol was being given by another. That's the kind of stuff we saw.

w.

BY MR. BOYLE:

Q. And in addiction medicine, a way you select data is by meeting and interviewing the patient, correct?

ww

A. That is part of the -- that is part, but not the only way we do that, yes.
Q. And I don't think anyone would disagree with you on this. And but here, obviously, you have not been able to meet
Mr. Jackson.

A. I have not, tragically. Would have liked to.

A. Correct.
Q. And similarly, you have not been able to meet anybody from his family, correct?

so
n

A. That's correct.

.co

Q. I'm sorry. Just for the record, here, unfortunately, you have not been able to meet Mr. Jackson, correct?

Q. And so you were not able to gather any data directly from Mr. Jackson or his family, correct?
A. That's correct.

ck

Q. And, sir, with regard to overcoming -- overcoming addiction, is it a fair statement that something that is important
to consider is a person's motivation to overcome the addiction?

ae
lJa

A. That is a complicated subject and I will try to make the answer short. Some people can overcome addiction with
very little initial motivation. Motivation down the road, once people have some time abstinent from the drugs, does
become important.
Q. And based on your experience, what kind of motivations have you seen that have enabled people to overcome their
addiction?

M
ich

A. Everyone gets their motivation from a different source. Some people might be motivated by their medical license or
their pilot's license or their, you know, law license. Other people might be motivated by family, by, you know, by
getting their pride and their name back. So motivation is a complex thing. And for each person, it's a little different.
Q. And, sir, did you see anything in the record regarding Mr. Jackson's selfless love for his children?
A. I did.

Mr. Jackson's relationship with his children to be?

am

Q. And what -- what did you understand

Te

A. Universally, what was stated in the record from many, many sources, is his dedication to his children, his
compassion with his children, his wanting the best for his children and his desires to be a good parent, I guess, would be
inferred from that.
Q. And, sir, is that the type of thing that if Mr. Jackson were given proper treatment for his addiction, that that type of
motivation for his children, could that have gotten him through the rough patches down the line?

w.

A. Certainly one could posit that that would be highly contributory to. There is more to it than that, but that would
posit that.

ww

Q. And so, you know, unlike some addicts who may not -- to use a very simple expression, may not have a lot to live
for in terms of family or career, Mr. Jackson was not that way, correct?

A. That's correct.

.co

Q. If Mr. Jackson had been given appropriate treatment and had he accepted that, he could have at least perhaps gotten
over the hump on the road to recovery, correct?

so
n

A. That -- you are assuming lots of different variables. And I think that there are other variables to account for his
prognosis long term, but his love for his children and his dedication to his children would certainly help.

Q. And, sir, did you see anything in the record that was given to you that the reason that Mr. Jackson was doing the
"This Is It" tour was because of his children?

ae
lJa

Q. And what is "addiction memory"?

ck

A. I remember some statements in the record that indicated that he wanted to have his children see him perform when
they were of age to remember that and that he wanted to be a good dad and an example.

M
ich

A. "Addiction memory" is a phrase that -- a phrase that I coined. It's not in the general parlance of addiction work, but
it's my effort to bring it into the fore. What happens when one becomes addicted is deep neural circuits entrain the brain
to preserve the behaviors, which make sure that the addiction continues, such as if someone finds out that they -- that
every time they go to John Smith's house, they can get hydrocodone, they can purchase hydrocodone, the route to John
Smith's house is deeply embedded in the brain. It retrains the brain to see that as important. It sets -- resets a high
priority. And it's what's called procedural learning. The brain literally learns unconsciously how to ensure that the drug
supply is maintained. And it is my belief is this is one of the crucial aspects of addiction, and unwinding is a crucial
thing to do in treatment.
Q. And so, sir, I saw on one of the videos on your website, you were talking about addiction memory and you used an
example of someone who is an alcoholic and they might have been off alcohol for a while and they're driving home from
work and the next thing they know, they are just in the parking lot of their old bar.

am

A. You really did watch that video, didn't you? Yes, that is my usual example.

Te

Q. So with Michael Jackson, would it be, to sort of put it in layperson's terms, when he found himself with a doctor,
that sort of triggered his unconscious desire for the drugs?

w.

A. Yes. And we even have a few examples of that in that in one case, he told -- I believe it was Dr. Adams -- I don't
want opiates, don't give me any Demerol, and then by the end of the procedure, he asked for Demerol. And so that was a
triggering of this circuit this -- it's a conditioned cue craving, something in the environment, being around the, doctor
triggered him to that kind of unconscious drive to find ways of and means of getting more.

ww

Q. And, sir, while -- and, sir, before we go on Exhibit , back on -- back on addiction memory, you brought up the
episode with Dr. Adams where Mr. Jackson started out saying don't give me the opiods and then by the end, he was
begging for them, right?
A. Begging is after overstatement, but he certainly requested them, yes.

A. Correct, yes.
Q. And is that the kind of tools that you taught at the Talbott Recovery to addicts?

so
n

A. Correct.

.co

Q. And, you know, is that something -- you had mentioned before about teaching the addict tools to -- so they can stop
it when they notice that they're unconsciously reaching out for the drugs, correct?

Q. And so what -- you know, what would you teach somebody with an opiod addiction about -- what tools would you
try to give them so they could notice when they were reaching out?

ae
lJa

ck

A. Well, I'm not supposed to say anything funny in a deposition, but the first thing he should do is avoid doctors,
because unfortunately, doctors became a drug source for him. So the first thing you do is you try to eliminate the highrisk situation. The high-risk situation for him, unfortunately, was being around physicians, physicians who have a
prescription pad, physicians who can write these substances.
Q. And I know no human really can avoid doctors for their whole life. So it would be that he just only go to doctors
when absolutely necessary.

M
ich

A. Only when necessary. And when he would need to go to a physician, he would prepare himself for that encounter
knowing that this unconscious drive would show up. It's ambivalence. On one hand, he was just as sincere at the
beginning saying "Don't give me any Demerol" as he was at the end saying "I want the Demerol." And that's part of trap
that he was in regarding this addiction.
Q. So it probably was not a good idea, sort of paradoxically, that he had a full-time, 24-hour doctor with him, correct?

am

THE WITNESS: You know, I think that having a doctor with him who has a prescription pad is -- can be a high-risk
situation unless properly prepared for it in someone who is chemically dependent.
Q. So based on your review of records in the case, did you see any evidence that any doctor other than Dr. Conrad
Murray gave Michael Jackson propofol during the last two months of his life?

Te

A. I saw nothing in the record about anyone else giving him propofol in the last two months of his life.

w.

Mr. Boyle asked you, in essence, you know, would it be right to blame Mr. Jackson for his death. And you spoke about
that from your perspective as an addiction physician. And do you recall that testimony?
A. Yes.

ww

Q. And just to be clear, were you speaking at all from a legal perspective there?
A. I was not.
Q. Do you have any legal opinions about fault for Michael Jackson's death?

n.c
om

A. Absolutely not. I am not a lawyer. Nor do I understand the law.

Q. And you also testified that being around physicians was sort of a high risk for someone like Mr. Jackson. Do you
recall that testimony?
A. I do.

lJa
ck
so

Q. Do you think that that means that it wasn't appropriate for Michael Jackson to have medical care?

A. No, that is not what that means. All that I meant by that testimony was that his -- that being around physicians
would trigger drug craving inadvertently, and the fact that there was the power differential was inverted. In other words,
physicians would -- Mr. Jackson would be in the power seat with physicians because of his incredible status. Those
things placed him at high risk for continued use or relapse if he had ever obtained substantive recovery.
Q. And, sir, in that discussion that -- you said something that caught my interest. You said one of the cardinal signs of
people who have addiction is that they have shame about their addiction, right?

Q. And similarly, they have self-loathing,

ae

A. Correct.
correct?

ww

w.

Te
a

mM

ich

A. The shame produces self-loathing in many individuals, yes.