A report by the Hillsborough County Medical Examiner a month after O'Neill's death concluded that the musician died from a combination of drugs in his system, including codeine, diazepam, and an antihistamine (via The New York Times). The real tragedy of O'Neill's death is that he actually died from a "chronic illness," the band wrote on their website after his death.
"Those who knew Paul were aware of his ongoing battles with his health and his propensity to overwork himself ... From the solitary weeks in the hotel while working in his Florida studio to jumping around on a pyro-filled stage, or flying around the country on no sleep aggravating his chronic spine problems after early life back surgery" (via the Trans-Siberian website). He also suffered for more than a decade with a painful and incurable case of Meniere's disease, a disorder of the inner ear.
Another reason O'Neill's death was such a tragedy? He was a kind-hearted, caring philanthropist, who donated millions of dollars to charity. According to his colleagues in TSO, he would literally give the shirt off his back to help a person in need, and in fact, they said, he was known to spot a homeless person and give them his jacket, with hundred dollar bills in the pocket.
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