Heath Ledger died of an accidental overdose of painkillers, sleeping pills, anti-anxiety medication and other prescription drugs, the New York City medical examiner's office said on Wednesday.
The cause of death was "acute intoxication by the combined effects of oxycodone, hydrocodone, diazepam, temazepam, alprazolam and doxylamine", the office said in a statement. "We have concluded that the manner of death is accident, resulting from the abuse of prescription medications."
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The examiners' office indicated that it believed Ledger's death was caused by a gradual build-up over time of the prescription drugs in Ledger's system rather than a sudden binge.
The drugs are the generic names for the OxyContin painkiller, the anti-anxiety drug Valium, Xanax, an anti-anxiety drug, and the sleep aids Restoril and Unisom. Hydrocodone is a widely used prescription painkiller.
A spokesman for the medical examiner would not say what concentrations of each drug were found in the actor's blood, or whether one drug played a greater part than another in causing his death. "What you're looking at here is the cumulative effects of these medications together," she said.