Throughout most of his life, Cobain suffered from chronic bronchitis and intense physical pain due to an undiagnosed chronic stomach condition.
His first drug experience was with marijuana in 1980, at age 13. He regularly used the drug during adulthood.
Cobain also had a period of consuming "notable" amounts of LSD, as observed by Tracy Marander,
Cobain's cousin Beverly, a nurse, claimed Cobain was diagnosed with attention-deficit hyperactivity disorder as a child, and bipolar disorder as an adult. She also brought attention to the history of suicide, mental illness and alcoholism in the Cobain family, noting two of her uncles who had committed suicide with guns.
Cobain's stomach condition was emotionally debilitating to him, and he intermittently tried to find its cause, usually at the insistence of Love. None of the many doctors he consulted were able to pinpoint the specific cause. He suffered from an acute self-consciousness and developed a poor body image, due to his low body weight; which was primarily due to malnourishment caused by his stomach condition, poor diet (as attributed by numerous doctors), or a combination of both.
He used heroin sporadically for several years, but, by the end of 1990, his use developed into a full-fledged addiction. Cobain claimed that he was "determined to get a habit" as a way to self-medicate his stomach condition. "It started with three days in a row of doing heroin and I don't have a stomach pain. That was such a relief," he related.
His heroin use began to affect the band's Nevermind supporting tour, Cobain fell unconscious during photo shoots. One memorable example came the day of the band's 1992 performance on Saturday Night Live, where Nirvana had a photographic session with photographer Michael Levine. Having taken heroin beforehand, Cobain fell asleep several times during the shoot. Cobain divulged to biographer Michael Azerrad, "I mean, what are they supposed to do? They're not going to be able to tell me to stop. So I really didn't care. Obviously to them it was like practicing witchcraft or something. They didn't know anything about it so they thought that any second, I was going to die."
Slowly, Cobain's heroin addiction worsened. His first attempt at rehab was made in early 1992, not long after he and Love discovered they were going to become parents. Immediately after leaving rehab, Nirvana embarked on their Australian tour, with Cobain appearing pale and gaunt while suffering through withdrawals. Not long after returning home, Cobain's heroin use resumed.
Prior to a performance at the New Music Seminar in New York City in July 1993, Cobain suffered a heroin overdose. Rather than calling for an ambulance, Love injected Cobain with Narcan to bring him out of his unconscious state. Cobain proceeded to perform with Nirvana, giving the public no indication that anything out of the ordinary had taken place.
Following a tour stop at Terminal Eins in Munich, Germany, on 1 March 1994, Cobain was diagnosed with bronchitis and severe laryngitis. He flew to Rome the next day for medical treatment, and was joined there by his wife on 3 March 1994. The next morning, Love awoke to find that Cobain had overdosed on a combination of champagne and Rohypnol. Cobain was immediately rushed to the hospital, and spent the rest of the day unconscious. After five days in the hospital, Cobain was released and returned to Seattle.Love later stated that the incident was Cobain's first suicide attempt.
On 18 March 1994, Love phoned Seattle police informing them that Cobain was suicidal and had locked himself in a room with a gun. Police arrived and confiscated several guns and a bottle of pills from Cobain, who insisted that he was not suicidal and had locked himself in the room to hide from Love. When questioned by police, Love said that Cobain had never mentioned that he was suicidal and that she had not seen him with a gun.
Love arranged an intervention regarding Cobain's drug use on 25 March 1994. The ten people involved included musician friends, record company executives, and one of Cobain's closest friends, Dylan Carlson. The intervention was initially unsuccessful, with an angry Cobain insulting and heaping scorn on its participants and eventually locking himself in the upstairs bedroom. However, by the end of the day, Cobain had agreed to undergo a detox program. Cobain arrived at the Exodus Recovery Center in Los Angeles, California on 30 March 1994. The staff at the facility were unaware of Cobain's history of depression and prior attempts at suicide. When visited by friends, there was no indication to them that Cobain was in any negative or suicidal state of mind. He spent the day talking to counselors about his drug abuse and personal problems, happily playing with his daughter Frances. These interactions were the last time she would see her father. The following night, Cobain walked outside to have a cigarette, climbed over a six-foot-high fence to leave the facility (which he joked earlier in the day would be a stupid feat to attempt). He took a taxi to Los Angeles Airport and flew back to Seattle. On the flight, he sat next to Duff McKagan of Guns N' Roses. With Cobain's own personal animosity towards Guns N'Roses and specifically Axl Rose, Cobain "seemed happy" to see McKagan. McKagan later stated he knew from "all of my instincts that something was wrong."On 2 April and 3 April 1994, Cobain was spotted in various locations around Seattle, although most of his close friends and family were unaware of his whereabouts. He was not seen on 4 April 1994. On 3 April 1994, Love contacted a private investigator, Tom Grant, and hired him to find Cobain. On 7 April 1994, amid rumors of Nirvana breaking up, the band pulled out of that year's Lollapalooza music festival.
On 8 April 1994, Cobain's body was discovered at his Lake Washington home by an electrician who had arrived to install a security system. Apart from a minor amount of blood coming out of Cobain's ear, the electrician reported seeing no visible signs of trauma, and initially believed that Cobain was asleep until he saw the shotgun pointing at his chin. A suicide note was found, addressed to Cobain's childhood imaginary friend "Boddah", that said, paraphrasing, "I haven't felt the excitement of listening to as well as creating music, along with really writing . . . for too many years now". A high concentration of heroin and traces of Valium were also found in his body. Cobain's body had been lying there for days; the coroner's report estimated Cobain to have died on 5 April 1994.
A public vigil was held for Cobain on 10 April 1994 at a park at Seattle Center drawing approximately seven thousand mourners.Prerecorded messages by Krist Novoselic and Courtney Love were played at the memorial. Love read portions of Cobain's suicide note to the crowd, crying and chastising Cobain. Near the end of the vigil, Love arrived at the park and distributed some of Cobain's clothing to those who still remained.Dave Grohl would say that the news of Cobain's death was "probably the worst thing that has happened to me in my life. I remember the day after that I woke up and I was heartbroken that he was gone. I just felt like, 'Okay, so I get to wake up today and have another day and he doesn't.'" He also believed that he knew Cobain would die at an early age, saying that "sometimes you just can't save someone from themselves," and "in some ways, you kind of prepare yourself emotionally for that to be a reality."Dave Reed, who for a short time was Cobain's foster father, said that "he had the desperation, not the courage, to be himself. Once you do that, you can't go wrong, because you can't make any mistakes when people love you for being yourself. But for Kurt, it didn't matter that other people loved him; he simply didn't love himself enough."
A final ceremony was arranged for Cobain by his mother on 31 May 1999, attended by both Courtney Love and Tracey Marander. As a Buddhist monk chanted, his daughter Frances Bean scattered his ashes into McLane Creek in Olympia, the city where he "had found his true artistic muse."
Cobain's artistic endeavours and struggles with heroin addiction, illness and depression, as well as the circumstances of his death have become a frequent topic of fascination, debate, and controversy throughout the world.