Whitney Houston was found “lying face down in the bathtub filled with water” in her hotel room on the day she died, according to the final autopsy report released Wednesday.

A white powdery substances and a spoon with white residue were found in the bathroom along with a rolled up piece of white paper. Although the report did not specifically identify the substance as cocaine, the coroner ruled that the “effects of atherosclerotic heart disease and cocaine use” were contributing factors in the singer’s accidental drowning.

On February 11, Houston’s assistant left her alone in her hotel room while she took a bath in preparation for a pre-Grammy Awards party. The assistant returned to find her lying face down in the bathtub in approximately 13-inches of water.

The 48-year-old singer had marijuana, Xanax, Benadryl and other medication in her system at the time of her death, according to a preliminary report released in March.