Hayden Panettiere‘s cause of death has been revealed.
The actress died last month at age 36 from the toxic effects of fentanyl as well as prescription drugs, including alprazolam, known by its brand name Xanax; methocarbamol, a muscle relaxant; and quetiapine, an antipsychotic used to treat schizophrenia, bipolar disorder and major depressive disorder.
The manner of death was ruled to be an accident, according to the Greenville County Coroner’s Office, which announced its findings early Tuesday.
An autopsy discovered no signs of trauma.
As previously reported, Panettiere was found unresponsive in a Greenville, South Carolina, residence, with first responders and EMS responding to a cardiac arrest. Resuscitation efforts were unsuccessful, and she was pronounced dead.
Panettiere, who began acting as a child, had been open about her struggles with substance abuse, revealing in 2022 that she spent years battling an addiction to opioids and alcohol.
“My saving grace is that I couldn’t be messy while on set and working,” she told People magazine at the time. “But things kept getting out of control [off set]. And as I got older, the drugs and alcohol became something I almost couldn’t live without.”
After welcoming daughter Kaya with ex Wladimir Klitschko, the Heroes and Nashville star struggled with postpartum depression, which she sought treatment for but continued to struggle with drinking and using opioids as her relationship with Klitschko crumbled.
“He didn’t want to be around me,” she said. “I didn’t want to be around me. But with the opiates and alcohol, I was doing anything to make me feel happy for a moment. Then I’d feel worse than I did before. I was in a cycle of self-destruction.”
Later, in an interview on Jay Shetty’s On Purpose podcast timed to the release of her memoir last May, which received renewed attention after her death, Panettiere explained how her postpartum struggles affected her use of drugs and alcohol.
“I never felt any hostility or negativity toward my child, thankfully, but I wasn’t connecting with her the way that I knew I should be, and I was full of stress and anxiety all the time,” Panettiere said. “That’s why I turned to substances — because [of] the anxiety that I started having, the panic attacks that I started having,”
She added, recalling how she’d long wanted to be a mom: “I had this beautiful plan in my head, and then I had my daughter, and I knew something was just terribly, terribly wrong. I was miserable. I was in tears all the time. Even though the alcohol helped my nervous system calm down, it is a depressant, so over time it made things worse, not better.”
Panettiere was in Greenville, South Carolina with her on-off boyfriend Brian Hickerson and his brother Zach Hickerson, both of whom called 911, according to a heavily redacted incident report from the Greenville Police Department.
When paramedics arrived, Brian Hickerson showed them a “bag of medication” he said she had been taking, according to the police report.
Zach Hickerson later told TMZ that Brian gave Panettiere Narcan, a medication used to reverse the effects of an opioid overdose.
Just days after Panettiere died, the Drug Enforcement Administration reportedly joined the investigation into her death.
Last week, TMZ reported that Panettiere died from taking a pill laced with fentanyl.
