Fifty years ago, the music that was Judy Garland abruptly stopped.

Her husband of only three months, a fellow who called himself Mickey Deans (his real name was Michael De Vinko), broke open a locked bathroom door in her London flat on June 22, 1969, only to find the singer and movie star slumped on the toilet with her hands still holding up her head. Although she looked much older, thanks to the ravages her body had endured for decades, Judy was only 47 at the time of her death.

A legion of fans from the 1940s to the present day have thrilled to Garland’s brilliant performances in such classics as “The Wizard of Oz,” “Meet Me in St. Louis,” “Easter Parade,” “Babes in Arms,” several “Andy Hardy” films, “Strike Up the Band,” “Babes on Broadway,” and her 1954 comeback film for the Warner Brothers, “A Star is Born” (for which she lost the 1955 Oscar for Best Actress to Grace Kelly, who starred with Bing Crosby in “The Country Girl”). But the star also suffered a lifetime of mental and physical health problems.

Active addiction is a slow but certain form of death.

After Garland’s body was discovered, Scotland Yard was called and an autopsy was conducted by the London coroner Dr. Gavin Thurston. The cause of death was listed as “Barbiturate poisoning (quinabarbitone) incautious self-overdosage. Accidental.”

There was also evidence of cirrhosis of the liver — unsurprising, given the amount of alcohol she routinely consumed — which may well have killed her had not the pills done the job first.

Thurston told the press, “This is quite clearly an accidental circumstance to a person who was accustomed to taking barbiturates over a very long time. She took more barbiturates than she could tolerate.”

Accidental is not exactly the word I would have used to make the final diagnosis.

Be it a predilection to alcohol, the now rarely prescribed barbiturates (then a common sleeping pill but extremely dangerous because of the risk of overdosing on them), “pep pills” (amphetamine), or the illicit drugs she was reported to have consumed while partying with musicians in swinging London of the late 1960s, active addiction is a slow but certain form of death. It is what one of my patients once called “a slow suicide for those too afraid to do it more quickly.”

According to her obituary in The New York Times, Garland’s ex-husband Sid Luft, a film producer, alleged that she attempted suicide on at least 20 different occasions, beginning at the age of 28. She was hospitalized many more times for many different health crises, ranging from “nervous breakdowns,” injuries after, literally, falling down drunk, and laryngitis and vocal problems.

A singer of remarkable power and range, Judy Garland (born Francis Gumm on June 10, 1922 in Grand Rapids, Minnesota) was one of the brightest stars in the firmament that was the Metro-Goldwyn-Mayer film factory of the 1940s.

Long before the tough times, while filming all those wonderful movies at MGM with an impossibly young Mickey Rooney, Judy was prescribed stimulants and depressants, which she claimed was at the direct order of the studio mogul, Louis B. Mayer. Making matters worse, her adolescence was not spent in a high school like normal American teens but, instead, at the studio, film premiers and parties with the likes of Lana Turner and Clark Gable.

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“They’d give us pep pills,” she recalled, “then they’d take us to the studio hospital and knock us cold with sleeping pills… after four hours they’d wake us up and give us pep pills again…that’s the way we worked, and that’s the way we got thin. That’s the way we got mixed up. And that’s the way we lost contact.”

Heavily drugged on a slurry of medications she had been legally prescribed by quack doctors since her earliest days at MGM, along with unhealthy doses of booze and opiates, she stumbled through her lines and songs. She fought bitterly with the alcoholic and troubled director Busby Berkeley, with whom she had a bitter history dating back to the 1942 film that introduced Gene Kelly to movie theatres, “For Me and My Gal,” a stunningly terrific musical in glorious black and white. (I challenge anyone to watch these two talented stars effortlessly sing and dance the title song without breaking into a warm smile.)

Mickey Rooney, incidentally, denied Judy’s version, telling more than one journalist, “Judy Garland was never given any drugs by Metro-Goldwyn-Mayer. Mr. Mayer didn’t sanction anything for Judy. No one on that lot was responsible for Judy Garland’s death. Unfortunately, Judy chose that path.”

Regardless of who gave whom drugs, Garland was a full-blown alcoholic and drug addict long before she turned 30, in an era when most Americans considered this rapacious killer to be a moral failing rather than a bona fide disease of the mind, body and soul.

In 1949, Garland was abruptly fired from playing Annie Oakley in the MGM production of “Annie Get Your Gun” for excessive tardiness, overweight, drunkenness, and “instability.” Only one month into filming, Betty Hutton was hired to fill Judy’s ruby slippers, so to speak.

After a lengthy hospitalization at the Peter Bent Brigham Hospital, she was given another chance to work, on the 1950 movie “Summer Stock,” with her old pal, Kelly. Judy’s weight ballooned and dropped during the filming, which is evident from watching the different scenes. Then cast in “Royal Wedding” alongside Fred Astaire, her tardiness and absenteeism led to a final dismissal from MGM. Despondent and depressed, she lightly grazed her throat with a shard of glass in a suicide attempt. Yet it was not the end of her life or career — she continued to perform on stage and screen, scoring one of her biggest roles in “A Star Is Born” a few years later.

As the New York Times opined, “perhaps the most remarkable thing about the career of Judy Garland was that she was able to continue as long as she did—long after her voice had failed and long after her physical reserves had been spent in various illnesses that might have left a less tenacious woman an invalid.”

Several years ago, when writing my book “An Anatomy of Addiction,” I attempted to explain the risks of a disease that begins with a voluntary action but soon transmogrifies into a deadly obsession. I was reminded of these words while thinking and writing about the American icon that was Judy Garland:

“Addictive agents, when taken chronically and copiously, can transform anatomy. Like an overloaded power switch, an insurgency of bad judgment and risky behavior hijacks the brain’s delicate circuitry, inducing temporary states of well-being and release from all inhibitions. Long after the high has disappeared, a neurologically mediated form of bondage forces the addict to pursue [her] own destruction. His body progressively demands greater amounts in exchange for briefer moments of escape amid a growing cascade of physical and mental health breakdowns. In the end, for the witness it is death at its most repellent and for the addict at its most seductive…Imagine this susceptibility as a wheel of misfortune that includes wedges depicting risks related to genetics, environment, mode of administration, and emotional or physical trauma. The addict’s luck runs short when the wheel stops at the most harmful wedges.”

Garland’s luck ran out 50 years ago, but the gifts she gave to the world, still available for all to watch and hear, remain our collective win.

If you or someone you know has talked about contemplating suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255, open 24 hours a day, seven days a week.