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Mac Miller’s Depression and Substance Abuse May Have Been a Dual Diagnosis

Photo of Mac Miller (2017) by Nicolas Völcker (Wikimedia commons)

Rapper Mac Miller — who was open about his substance abuse in his music and interviews — died Sept. 7. As of this writing (Sept. 10), the toxicology reports had not been released yet, but no “apparent” cause of death, drug-related or otherwise, was discerned by the medical examiner. Still, given his past substance abuse, drugs are suspected.

Miller was highly regarded as a rap artist. Just today The New Yorker — not normally thought of as a rap organ — published a long, lavish obituary and assessment of his career. He was purportedly generous with his time and money, working with other, lesser-known musicians and helping them.

Even so, you may know of Miller mainly as the ex-boyfriend of ex-Disney singer-actress Ariana Grande, who, just weeks after breaking up with Miller, became engaged to Saturday Night Live featured performer and recovering alcoholic Pete Davidson. Grande has said she broke up with Miller because the relationship was “toxic”, presumably because of his continued drug use, and that it was “hard” and “scary”.

Among the drugs Miller admitted to having abused at one time or another:

  • Alcohol
  • Tobacco
  • Marijuana
  • Cocaine
  • Phencyclidine (PCP) or “angel dust”
  • Lean”: a mix of promethazine (an antihistamine) and codeine (an opiate), a combination also sometimes known as “sizzurp”, “liquid heroin” and “purple drank”.

In a July interview Miller told Rolling Stone that he had stopped all drug use, but since Grande says she broke up with him at about the same time because of his drug use, he may have been lying. Relapse is common among people with substance abuse, even after years of abstinence (Philip Seymour Hoffman, Demi Lovato). Sometimes they go on to recovery again, but sometimes they aren’t that lucky.

Miller said the main reason he abused drugs and alcohol was depression brought on in part by his industry success. He also said he likes life’s ups and downs and hated being sober.

Mac Miller may have been a case of dual diagnosis, of substance abuse and another mental illness, such as bipolar disease. Such patients frequently self-medicate with illegal drugs or abuse of legal drugs such as prescription pills or alcohol. Miller stopped using marijuana because he felt it was making him paranoid. Lean is mainly a sedative.

Lean was or is a popular drug among the hip hop community. Videos show rappers and fans alike drinking it, normalizing it. Even so, Miller said he stopped using it years ago.

It’s possible that Miller’s death had nothing to do with drug abuse, other than possibly having weakened his system through years of abuse, making his untimely death more likely. Or he may have been drinking heavily and stopped cold turkey. That can lead to death, as actor Nelsan Ellis (Lafayette on True Blood) demonstrated last year.

One suspicious circumstance: Authorities told website TMZ that Miller’s residence was possibly “swept clean”, based on witness testimony and only a small amount of white powder was found on site. Whether this was done (if it was done) to protect Miller’s reputation or possibly a friend or drug supplier isn’t known. 

If drugs or alcohol were involved, Miller’s death may become another teaching moment. It seems we’ve had far too many of those lately.