A cause of death has been determined for singer Aaron Carter.
The musician, 34, drowned after inhaling difluoroethane and taking alprazolam, according to the Los Angeles Country Medical Examiner-Coroner. Difluoroethane is a gas often used in cans of compressed air, while alprazolam is the generic form of brand-name Xanax.
The report, obtained by PEOPLE, states Carter was "incapacitated while in the bathtub" as the drugs took effect, slipping under the surface of the water and ultimately drowning.
TMZ was first to report the news.
Carter was found dead at his home in Lancaster, California on Nov. 5. Police sources told PEOPLE at the time that he was found in his bathtub by a house sitter, and that there were prescription pills and drug paraphernalia in his bedroom.
The insiders said at the time that it was believed Carter likely lost consciousness and drowned.
Drowning is the third-leading cause of unintentional injury death around the world, according to the organization Stop Drowning Now, and alcohol use is involved in nearly one in four emergency department visits for drowning, per the Centers for Disease Control and Prevention.
Singers Whitney Houston and Dolores O'Riordan of The Cranberries were also both determined to have died in their bathtubs by accidental drowning while under the influence.
Houston had cocaine in her system when she died in the tub of a Los Angeles hotel room in 2012, while O'Riordan had alcohol and prescription medication in hers when she died in 2018 in a London hotel.
Carter, who released his fifth and final album, LØVË, in 2018, was remembered in emotional statements shared by older brother Nick Carter, 42, and twin sister Angel Carter, from both of whom he'd become estranged in recent years.
"My heart has been broken today," Nick wrote in part. "Even though my brother and I have had a complicated relationship, my love for him has never ever faded. I have always held onto the hope, that he would somehow, someday want to walk a healthy path and eventually find the help that he so desperately needed."
Angel wrote, "To my twin… I loved you beyond measure. You will be missed dearly. My funny, sweet Aaron, I have so many memories of you … and I promise to cherish them. I know you're at peace now. I will carry you with me until the day I die and get to see you again. 💔."
A source told PEOPLE shortly after his death that Carter was still reeling from the sudden deaths of several family members, including his sister Leslie, who died of an overdose in 2012 at age 25, and dad Robert, who died in 2017 of an apparent heart attack.
"Aaron never really dealt with a lot of trauma he had," the insider said. "He was really torn up when Leslie died, but it was Bob's death that really threw him."
Carter had faced legal troubles and struggled with addiction over the years, for which he sought treatment. He was pulled over for suspicion of DUI less than a week before his death, but officers found that he wasn't under the influence after conducting a field sobriety test, TMZ reported.
