Chris Cornell, legendary rock star and frontman of the bands Soundgarden and Audioslave, was found dead on May 18, 2017. His death, according to the Medical Examiner of Wayne County, Michigan, was declared to be one by suicide: Chris Cornell reportedly hung himself in his Detroit hotel room after playing his last show earlier that Wednesday night.

Chris Cornell’s toxicology report, released just this month, revealed that several prescription drugs were in his system that night. The artist had high levels of barbiturates (prescription sedatives) and four doses of lorazepam (also known as the anxiety medication Ativan) in his body at the time of death. Traces of caffeine (an upper), pseudoephedrine (a decongestant), and naloxone (administered by EMTs to stop a possible overdose) were also revealed in the toxicology report.

Despite evident signs of prescription drug abuse, the coroner officially determined that Chris Cornell’s drug abuse did not directly cause his death. This was not an overdose, and experts say it is unlikely that the “weird combination” of uppers and downers in Cornell’s system would lead him to hang himself.

The Cornell family is still unsettled by the report’s findings. Chris Cornell’s wife, Vicky, is especially taken aback by the news. She spoke with him just hours before his passing, and knew something was seriously wrong by the slurring of his voice. She had not heard Chris sound like that since his Oxycontin addiction 14 years ago. When she asked what was wrong, Chris told Vicky he may have taken too many Ativans.

Ativan – a drug that Chris Cornell had been prescribed for anxiety – can stir suicidal thoughts in a user. Mixed with barbiturates and caffeine, it can also lead to drowsiness and disorientation. An average, prescribed dosage of Ativan is around 30-50 ng/mL. Chris Cornell had 200 ng/mL in his system at the time of death. However, the medical examiner stated that those who die from too much Ativan typically take 300 ng/mL, and with that said, he could not tie Cornell’s death directly to his Ativan abuse.

In a statement to Rolling Stone, Vicky Cornell responded, “Many of us who know Chris well noticed that he wasn’t himself during his final hours and that something was very off. We have learned from this report that several substances were found in his system. After so many years of sobriety, this moment of terrible judgment seems to have completely impaired and altered his state of mind.”

Chris Cornell had long struggled with drug abuse and addiction. He started using around age 12, and by the time he was 13-years-old, he had become a daily drug user – of pot, pills, or whatever was easily accessible at the time. When he was just 14, Chris Cornell had a bad experience with PCP (a dangerous hallucinogen) and wound up with a longer-lasting panic disorder – agoraphobia. For the two years following that experience, Cornell rarely talked to anyone and did not have any friends. He had debilitating flashbacks of his PCP trip and stayed home most of the time. He became depressed.

Though Cornell stayed away from hard drugs for years after that, he drank heavily from adolescence to his late thirties. He was the child of two alcoholics and felt his own drinking problem was nearly inevitable. In a 2006 interview with SPIN magazine, Cornell explained that it was alcohol that eventually led him back to drug abuse:

“I think alcohol is what leads you to everything, because it takes away the fear. The worst drug experimentation I ever did was because I was drunk and didn’t care.” By everything, Chris Cornell primarily meant prescription medications. When things got hard at home, he hit the bottle and took some pills, leading him to an even more severe state of depression and addiction.

Chris Cornell’s drugs and alcohol abuse brought him to rehab in 2002, when the other band members of Audioslave expressed their concern. He remained sober for five-plus years following that treatment, and steered away from any mood-altering substances long after that point.

While we recently discussed the connection between drug abuse and suicide, the reports regarding Chris Cornell’s death have moved Turnbridge to revisit the subject. As a residential, young adult drug treatment center, we fully understand the dangerous effects that drugs can have on a user – how he thinks, how he feels, how he behaves. Drugs, over time, physically re-wire a user’s brain chemistry and can cause lasting effects on a person’s emotions and state of mind.

Chris Cornell’s history of drug abuse and depression exhibit this relationship clearly. He battled many demons throughout his life, including loneliness, fear, panic, dependence, and addiction. Like millions of Americans out there, Chris Cornell self-medicated his depression with alcohol and drugs. He also took an Ativan prescription to help with his anxiety and panic disorder.

Mood disorders are the leading cause of suicide today, with depression being the most common driver. The second leading cause of suicide is drug and alcohol abuse. Depression and suicidal thoughts are a common side effect of drugs, meaning certain drugs may put a user at a heightened risk for self-harm.

The facts are clear:

• Depression is about three times greater in people who are battling addiction
• Those fighting substance use disorders are six times more likely to attempt suicide
• One in three people who commit suicide are under the influence of drugs

Mood disorders and substance use disorders affect the same areas of the brain, the areas responsible for pleasure and pain. People who abuse drugs and alcohol (especially depressants) may experience chemical-induced suicidal thoughts. All the while, people who experience depressive thoughts may use drugs to feel better. It is a vicious cycle; one that may have played a part Chris Cornell’s death.

After prolonged use, drugs can actually increase negative thoughts and behaviors in users. This is true of the medication Ativan, which if misused, can intensify negative feelings in people with a history of depression or suicidal ideation. And when high doses of Ativan wear off, it can leave a user even more anxious, irritable, and distressed than before.

Categorized as a highly-addictive benzodiazepine, Ativan can also cause unusual behaviors, slurred speech or trouble speaking, shakiness, and blackouts (anterograde amnesia) if taken in high doses. When a user blacks out on Ativan, he or she is also more likely to participate in dangerous behaviors like driving under the influence or attempting suicide. These side effects are especially enhanced when Ativan is combined with other substances like barbiturates or alcohol.

Still, Chris Cornell’s suicide was not determined to be a direct result of prescription drug abuse. If this were the case, experts say, it is highly likely that he was also dealing with an underlying, co-occurring mental health disorder, one that maybe his family, friends, and fans did not outwardly recognize. Cornell once stated (in response to Whitney Houston’s death), “Anyone that suffers depression and addiction, as it relates to the entertainment business, often there can kind of be a cocoon [around them].” It’s likely that he, too, had his own cocoon hiding deep-rooted battles with depression.

And it led to this.

If your loved one is battling a mental health disorder like depression, it so important to seek out the help he or she needs – especially if drug abuse is also at play. The combination of drugs and depression can be serious and fatal if left unaddressed. If your loved one is using drugs, look for signs and symptoms of depressive behaviors. Be aware of any potential cries for help, and if you can, get help before that cry even occurs. It is never too early for drug intervention or dual diagnosis treatment. You can save a life by pulling your loved one out of this vicious cycle, this chronic brain disorder, called addiction.

To get help for a mental health or substance abuse disorder, contact Turnbridge at 877-581-1793.