How Did Elvis Die? Here’s the Truth About His Cause of Death & Whether Drugs Were Involved

Elvis Presley
Photo: Everett Collection.

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It’s been over 45 years since his death, but questions about the King of Rock ‘n’ Roll’s final moments continue to circulate to this day. And even after the release of his 2022 biopic, many are still wondering: how did Elvis die?

At the time of his death at the age of 42, Elvis was one of the most renowned artists in the world. His passing shook the nation and prompted President Jimmy Carter to declare that the country lost a “part of itself” that day. “He was unique and irreplaceable,” Carter told the American public. “More than 20 years ago, he burst upon the scene with an impact that was unprecedented and will probably never be equaled. His music and his personality, fusing the styles of white country and black rhythm and blues, permanently changed the face of American popular culture.”

However, as the world continued to grieve Elvis’ passing, several mysteries surrounding his death persisted. The biggest question even all these years later remains: how did Elvis die?

When did Elvis die?

Elvis Aron Presley died in his Graceland mansion in Memphis, Tennessee, on August 16, 1977. He was discovered by his then-fiancée, Ginger Alden, who found him unconscious in their master bathroom. Elvis was quickly rushed by ambulance to Baptist Memorial Hospital, where he was ultimately declared dead at 3:30 PM following unsuccessful attempts to resuscitate him.

How did Elvis die?

Elvis Presley

Image: Everett Collection.

So, how did Elvis die? It all began on the morning of August 16, 1977, when Elvis told his then-fiancée, Ginger Alden, that he was going to the bathroom to read. The “Jailhouse Rock” star notoriously suffered from long bouts of constipation due to a combination of his diet and use of prescription painkillers, and took a copy of Frank Adams’ The Scientific Search for the Face of Jesus with him to the bathroom to keep himself occupied. According to her 2015 memoir, Ginger and Elvis
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Ginger, who was still half-asleep herself, told Elvis not to fall asleep on the toilet.

Hours passed. Ginger, who had gone on about her day as normal, began to realize that she saw no sign of Elvis around their Graceland mansion. This was unlike her fiancé, who was due to leave for the U.S. leg of his latest tour later that evening. A little after 2 o’clock in the afternoon, she went in search of the singer, only to find that the door to their master bedroom was ajar. When she peered inside, she encountered Elvis slumped over their toilet. “I stood paralyzed as I took in the scene,” she wrote in her 2015 memoir. “Elvis looked as if his entire body had completely frozen in a seated position while using the commode and then had fallen forward, in that fixed position, directly in front of it.”

By the time she found him, Ginger described Elvis’ face as looking “blotchy, with purple discoloration,” with eyes that were “staring straight ahead and blood red.” An ambulance was immediately called, arriving to the scene at 2:33 PM. Minutes later, Elvis was rushed to the emergency room at Baptist Memorial Hospital, where doctors made unsuccessful attempts to revive him. Elvis was officially pronounced dead at 3:30 PM, and the world’s media was informed within the hour.

Elvis Presley

Image: Everett Collection.

Three physicians—Eric Muirhead, Jerry Francisco and Noel Florredo—conducted an autopsy on Elvis the same day he passed away. While the postmortem examination took two hours to complete, Francisco decided to make a public statement about Elvis Presley’s cause of death midway through the process without the consent of his fellow pathologists. He cited “preliminary autopsy data” and announced to the press that Elvis Presley’s cause of death was “cardiac arrhythmia,” a.k.a., a heart attack. Francisco also claimed at the time that there was no indication that drugs played a role in his death. When pressed for details to confirm whether or not drugs were involved, Francisco dodged reporters, claiming that “the specific cause [of Elvis’s death] may not be known for a week or two pending lab studies. He added, “It is possible in cases like this that the specific cause will never be known.”

However, several weeks and a toxicology report later, Elvis Presley’s cause of death was confirmed—and the results weren’t quite as simple as Francisco let on. As it turns out, drugs did factor into Elvis Presley’s cause of death. Keep on reading ahead for what we know about the truth of how Elvis died.

What was Elvis Presley’s cause of death?

Elvis Presley

Image: Everett Collection.

So, what was Elvis Presley’s cause of death? While Elvis Presley died of heart failure, the cardiac episode is now believed to have been brought on by the “Hound Dog” singer’s long history of prescription drug abuse.

According to Presley’s toxicology report, which arrived several weeks following his death in August 1977, the rockstar had significantly high levels of Codeine, Dilaudid, Percodan and Demerol in detected in his blood, plus another 10 narcotics in his system. Elvis was a longtime opiate user, having also abused sleeping pills, antihistamines, barbiturates and, lastly, laxatives to treat intense constipation caused by his prescription-grade painkillers. In his final moments, Elvis likely strained so hard to pass a bowel movement that the effort put an extreme amount of pressure on his heart, resulting in cardiac arrest. Yet at the time of his passing, it seems that medical examiner Francisco purposefully left out these additional details in a bid to satisfy the Presley family, who were desperate to try to keep the rockstar’s drug use a secret and maintain his public image after his death.

In the years to come, Elvis Presley’s personal physician, Dr. George Nichopoulos (otherwise known as Dr. Nick) was indicted on felony charges for overprescribing and overdistributing controlled substances to a number of celebrity clients. In the last eight months that Elvis was alive, Nichopoulos prescribed over 10,000 doses of amphetamines, barbiturates, narcotics, tranquilizers, sleeping pills, laxatives and hormones to the star. Nichopoulos, who first began treating Elvis in 1967, claimed he provided the astonishing number of drugs in an effort to keep Elvis from resorting to illegal substances “on the street.” While he was acquitted on all charges, the Tennessee Board of Medical Examiners eventually terminated his medical license for good in 1995.

Elvis and Me by Priscilla Beaulieu Presley

"Elvis and Me" by Priscilla Presley

Image: Courtesy of Berkley.


For more about Elvis, read Priscilla Presley’s 1986 memoir, Elvis and Me: The True Story of the Love Between Priscilla Presley and the King of Rock N’ Roll
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In the book, Priscilla takes readers through her and Elvis’ relationship, from the moment they met to their marriage to their affairs and eventual divorce. The New York Times bestseller also reveals never-been-told details about Priscilla and Elvis’ relationship and why she still considers their bond “unbreakable” decades after his death. Described as a “tribute to both the man and the legend” that was Elvis, Elvis and Me is a must-read for any Elvis fan and written by the woman who loved him—in her own words.

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