How did Heath Ledger really die? His drug use and health problems detailed

By Chege Karomo — ON Jun 15, 2022
heath ledger
Heath Ledger photographed for Premiere Magazine on September 10,2006. at the Toronto Film Festival in Toronto, Canada. | Photo by Bryce Duffy/Corbis

Diana Wolozin arrived at Heath Ledger’s apartment on 22nd January 2008 to give the actor his regular massage. Teresa Solomon, the housekeeper, let her in and knocked on Heath’s door. Ledger didn’t come out, so Diana entered the bedroom and started preparing as Heath lay on the bed. She then shook Heath Ledger but received no response. 

A little over half an hour later, medical workers had pronounced Heath dead. As word of the beloved actor’s death spread, a crowd gathered outside his apartment at 421 Broome Street. Cameras flashed as authorities pushed out Heath Ledger’s body. Heath was 28 years old when he died. 

Key Takeaways

  • Heath’s death was an accident caused by an unfortunate and lethal combination of prescription medication. 
  • Before Ledger’s passing, his sister warned him about combining prescription drugs, but Heath didn’t listen. 
  • Federal authorities didn’t figure out how Heath acquired oxycodone (OxyContin) and hydrocodone (Vicodin). 
  • Ledger suffered from bouts of insomnia, which often hit him during filming. 
  • Heath likely used recreational drugs, but they didn’t cause his death. 

A lethal combination of prescription drugs killed Heath Ledger

A two-hour autopsy conducted at the medical examiner’s headquarters a day later yielded inconclusive results. “If you have no apparent cause, you have to do further testing,” Ellen Borakove, the spokeswoman for the medical examiner’s office, said. 

The office hoped that toxicology and histology tests would yield results. Borakove added: “Toxicology is done on blood and urine and what is in the stomach contents. It does not take one day. It takes 10 days to two weeks.”

New York City medical Examiners Office move the body of Heath into a vehicle outside of his apartment building were he was found dead January 22, 2008 | Photo by Stephen Lovekin/Getty Images

As the world waited for the results, wild theories about Ledger’s death emerged, with most claiming that he’d committed suicide. After a two-week wait, the medical examiner’s office concluded that Heath Ledger died due to an accidental and lethal combination of prescription drugs. Ellen Borakove said:

“Mr. Heath Ledger died as a result of acute intoxication by the combined effects of oxycodone, hydrocodone, diazepam, temazepam, alprazolam, and doxylamine. We have concluded that the manner of death is accident, resulting from the abuse of prescription medications.”

Oxycodone and hydrocodone are painkillers: Oxycodone is the active ingredient in OxyContin, and hydrocodone is often mixed with acetaminophen in drugs like Vicodin. 

Diazepam, temazepam, and alprazolam, commonly known as benzodiazepines, are anti-anxiety medications: diazepam and alprazolam are generic names for Valium and Xanax, while temazepam is often prescribed as the sleep aid dubbed Restoril rather than as anti-anxiety medication. 

Doxylamine is a nonprescription drug used to treat insomnia and relieve cough symptoms. 

Experts speaking to Today said that one doctor couldn’t have prescribed the drugs due to their combined effect on the nervous system. Jane Prosser, a medical toxicologist, said:

“If you see one doctor for one thing and you see another doctor for another thing, neither the physician nor the patient may realize they’re getting two similar medications. Patients should be aware that this happens on a regular basis and it doesn’t just happen to celebrities.”

Heath’s sister warned him the night before not to combine medications

“His sister was on the phone to him the night before telling him not to take the prescription medications with the sleeping tablets,” Heath’s father, Kim Ledger, told “He said, ‘Katie, Katie, I’m fine. I know what I’m doing.”

Heath Ledger parents and her sister
Heath’s parents Kim and Sally with his sister Kate outside their home in Perth, 23 January 2008 | Tony Ashby/afp Via Getty Images

After the medical examiner’s office publicized Ledger’s cause of death, Heath Ledger’s publicist Mara Buxbaum released a statement from his family. 

Kim Ledger said that the grieving family had been humbled by the overwhelming support granted by Heath’s fans worldwide. Heath’s father reiterated that the actor didn’t overdose:

“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.”

Ledger stated that the family had spent two fun-filled weeks with Heath in late 2007. “Those recent precious days will stay with us forever,” Kim said. The elder Ledger described Heath as a ‘consummate artist whose passions included photography, music, chess, and directing.’

“We treasure our beautiful granddaughter Matilda (to our dear Michelle) as well as an unbelievably wonderful network of close friends, forever, around the world,” Kim added. Hedger was cremated at a private funeral service attended by close family members. 

After his memorial service at a private girls’ school in Perth, Australia, mourners went to a beachside restaurant for a wake. Kim Ledger later said that Heath caused his own death:

“It was totally his fault. It was no one else’s — he reached for them. He put them in his system. You can’t blame anyone else in that situation. That’s hard to accept because I loved him so much and was so proud of him.”

It remains unclear where Heath got oxycodone and hydrocodone

“Six different sedative drugs in Heath Ledger’s systems show something was amiss,” Dr. Vatsal G. Thakkar, a psychiatrist, told The New York Times. “Whether that was in taking combinations of drugs without proper medical guidance or sloppy prescribing, it was an unfortunate situation and with a tragic outcome.”

Federal investigators launched a probe to determine how Heath got hold of the drugs, especially oxycodone and hydrocodone. Doctors in London had prescribed the three anti-anxiety drugs and the sleeping pill was a nonprescription drug. 

The Drug Enforcement Administration investigated a doctor from Houston and another from California. After reviewing records and interviewing the doctors, the DEA cleared them of wrongdoing. 

Heath Ledger and Mary-Kate Olsen
Heath Ledger and Mary-Kate Olsen | Sean Gallup/Getty Images | Jamie McCarthy/Getty Images

Investigators then turned their attention to Mary-Kate Olsen, Heath’s close friend. Their friendship came to light after Heath’s death. The pair must have been very close, considering Heath’s masseuse called Mary-Kate before dialing 911

Mary-Kate’s attorney Michael C. Miller denied that Olsen gave Ledger the drugs: “Despite tabloid speculation, Mary-Kate Olsen had nothing whatsoever to do with the drugs found in Heath Ledger’s home or his body, and she does not know where he obtained them.”

People reported that Mary-Kate wanted immunity before agreeing to cooperate with the investigation. Michael C. Miller:

“We have provided the government with relevant information including facts in the chronology of events surrounding Mr. Ledger’s death and the fact that Ms. Olsen does not know the source of the drugs Mr. Ledger consumed.”

The US Attorney’s Office subpoenaed Mary-Kate Olsen but closed the investigation into Ledger’s overdose death without enforcing the summon. A grand jury subpoenaed Olsen in April 2008, but following negotiations with federal authorities, the government ended its investigation into the actress. 

Ledger often complained of lack of sleep and probably had untreated pneumonia

It made sense for Heath to have sleeping pills, given his problems with insomnia. He told The New York Times that he rarely slept when filming a role. 

“Last week I probably slept an average of two hours a night,” he told the publication about filming The Dark Knight. “I couldn’t stop thinking. My body was exhausted, and my mind was still going.”

Ledger said that he took an Ambien that failed to work. He took another one that knocked him out for one hour. Heath’s friend Gerry Grennell lived with Heath during the final weeks of his life and witnessed the actor’s crippling insomnia. Grennell said:

“I would hear him wandering around the apartment and I’d get up and say, ‘Come on, man, get back to bed, you have to work tomorrow.’ He said, ‘I can’t sleep, ma.’”

Heath Ledger and Michelle Williams
Heath Ledger and Michelle Williams arrives at the Oscar Nominees Luncheon February 13, 2006 | Photo by Kevin Winter/Getty Images

Michelle Williams, the mother of Heath’s daughter Matilda, told Interview magazine that Ledger had regular bouts of Insomnia. Williams said:

“For as long as I’d known him, he had bouts with insomnia. He had too much energy. His mind was turning, turning, turning – always turning.”

Ledger was shooting The Imaginarium of Doctor Parnassus when he passed away. Christopher Plummer told People that the cold conditions experienced during filming caused illnesses in most actors, including Heath. Plummer said:

“We all caught colds because we were shooting outside on horrible, damp nights. But Heath’s went on and I don’t think he dealt with it immediately with the antibiotics. I think what he did have was the walking pneumonia.”

Furthermore, Plummer told People that Ledger was complaining of lack of sleep. “He was taking all these pills [to help him],” Christopher added. 

Heath likely used cocaine and heroin, but they didn’t contribute to his death

In late January 2008, The New York Post reported that Michelle Williams had driven Heath to Promises Treatment Center in Malibu, California, to seek treatment for his drug use. Ledger allegedly refused treatment and resolved to get clean on his own. 

Ledger broke his promise, leading to his separation from Michelle and departure from the couple’s apartment. Michelle allegedly demanded that Ledger be drug-tested before meeting Matilda. 

In most celebrity overdose cases, the people who discover their bodies decline to call emergency services first. They allegedly do this to clean up the scene before police arrive. In Heath’s case, his masseuse called Mary-Kate Olsen before calling 911. 

The call raised suspicion that drugs were at the scene, and the masseuse needed to know how to dispose of them. Police found a rolled-up 20-dollar bill on Heath’s bed but didn’t find evidence of drugs on the currency. 

Heath Ledger is photographed for Premiere Magazine on September 10, 2006 | Photo by Bryce Duffy/Corbis

It’s no secret that Heath drank alcohol and used marijuana for most of his life. However, it’s uncertain whether Ledger used cocaine and heroin or abused prescription drugs. 

A woman who had a brief fling with Ledger after he moved into his apartment in the SoHo neighborhood of Manhattan told New York magazine that she never saw Heath use drugs:

“He had a party at his loft once, and it was really crazy. There were drugs there, but he didn’t touch them. I saw it offered to him multiple times. Ecstasy, cocaine, even prescription stuff—but he never touched it. I was with him at least a dozen times, and he was always sober. Just cigarettes.”

Ledger denied using heroin and cocaine, but he probably used those drugs, The New York article concluded. However, recreational drug use didn’t change Heath or contribute to his passing. 

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