A toxicology report reveals that the Soundgarden frontman had taken Ativan, barbiturates, a decongestant, and caffeine pills before his death.
Credit: Taylor Hill/Getty Images

Soundgarden frontman Chris Cornell had several prescription medications in his system at the time of his death, according to People and a toxicology report obtained by TMZ. The singer hung himself in his hotel room in Detroit on May 18, and his family previously said that they believed the anti-anxiety drug Ativan may have influenced his final moments.

However, Wayne County assistant medical examiner Theodore Brown ruled Cornell’s death a suicide, and he wrote in his report that “these drugs did not contribute to the cause of death,” according to Rolling Stone.

Multiple sources stated Friday that Cornell did have Ativan (generic name lorazepam) in his system—the equivalent of four tablets. The Detroit News had previously reported that Cornell’s bodyguard gave him “two doses” of the medicine, which Cornell had been prescribed to treat anxiety, shortly after the band’s concert had ended that night.

While the amount of Ativan in Cornell’s blood (200 ng/mL) was higher than the average dosage, the toxicology report (as reported by Rolling Stone) noted this is still lower than levels (300 ng/mL and higher) that have previously been linked to fatalities.

Asher Simon, MD, assistant professor of psychiatry at The Mount Sinai Hospital in New York City, told Health that—in the absence of alcohol or other drugs—taking an extra Ativan or two would not cause serious impairment. Dr. Simon did not treat Cornell, but he spoke with Health the day after the musician’s death, and again in a follow-up interview today.

But Cornell did have butalbital, a prescription-strength barbiturate, in his system. Butalbital is a pain reliever and muscle relaxer, and it is sometimes prescribed to treat migraines or seizures. Butalbital not a first-line treatment, says Dr. Simon, especially not for people with a history of drug abuse. (Media reports have not established why or if Cornell, a recovering addict, had a prescription for this drug.)

“Unlike benzodiazepines—like Ativan—barbiturates are lethal in overdose and they’re highly addictive,” he says. “Even in normal doses, they can make you feel out of it, can make you feel intoxicated.”

Pseudoephedrine and caffeine were also in Cornell’s toxicology report. “The caffeine came from No-Doz tablets the singer ingested prior to his death, while the pseudoephedrine was employed as a decongestant,” Rolling Stone reported after obtaining the document.

Medicines containing pseudoephedrine are available without a prescription, but an ID is required for purchase because they can be used to make methamphetamines. “Pseudoephedrine has similar effects to amphetamines in the brain,” says Dr. Simon.

“The pseudoephedrine and the caffeine are basically uppers, and the barbiturates are basically a downer,” he continues. “None of these in and of themselves are so bad, and even in low doses in combination they would not cause death—but depending on the dosage, they could potentially have strange effects on cognition and perhaps on judgment.”

The drug naloxone (brand name Narcan) was in Cornell’s system as well. Naloxone is often carried by police, paramedics, and other trained professionals, and is used to reverse the effects of an opioid overdose. TMZ reported that EMTs injected naloxone while attempting to treat Cornell, to counteract other drugs he might have had in his system.

Following the release of the toxicology results, Cornell’s widow acknowledged the report’s findings. “After so many years of sobriety, this moment of terrible judgment seems to have completely impaired and altered his state of mind,” said Vicky Karayiannis Cornell in a statement to People. “Something clearly went terribly wrong and my children and I are heartbroken and are devastated that this moment can never be taken back.”

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Dr. Simon says he doesn’t like to prescribe benzodiazepines (like Ativan) and barbiturates (like butalbital) together, but adds that there could have been reasonable explanations why Cornell was taking both. And based on the combination of drugs in the toxicology report alone, Dr. Simon agrees with the medical examiner’s cause-of-death conclusion.

Could these drugs be related somehow to his hanging? Dr. Simon believes that they may have lowered Cornell's inhibitions, “but again they won’t cause suicide in and of themselves," he adds.