DISCLAIMER: An official cause of death has not yet been released for Blake Painter. The purpose of this article is to examine known and reported facts about drug addiction, which include how stress and chronic pain can lead to prescription drug misuse, illicit drug abuse, and an increased risk of overdose. It has not been confirmed that Painter died of an overdose at this time. On May 25th, Blake Painter, one of the Captains featured on the 2nd and 3rd seasons of the Discovery Channel’s popular reality TV show Deadliest Catch, was found dead in his home in Oregon. Although an official cause of death has yet to be released, multiple drugs, including prescription medications, were found on-site. He was only 38 years old. From the outside, Painter lived an enviable life. Professionally, he was a former crab fisherman who attained the rank of Captain. He even achieved a considerable level of celebrity after being featured on a show seen by millions. But privately, he struggled with chronic pain, substance abuse, legal problems, and the overwhelming daily stress of holding one of the most dangerous jobs in America. Clatsop County Sheriff Tom Bergin said there were no signs of suspicious circumstances or of foul play. This legal definition does not exclude the possibility of overdose, which, given Painter’s recent issues, must be given serious consideration. With that in mind, let’s take a closer look at what we can learn from the tragedy of a life cut too short.
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Who Was Blake Painter?
Painter was born and raised in Astoria, Oregon, and he started fishing at the age of three. Clatsop County is on the Oregon coast, west of Portland and close to the Washington State border. The area has abundant natural resources, and commercial fishing employs thousands of state residents. In fact, in 2017, there were 302 million pounds of fish and shellfish collected in Oregon. He was a second-generation fisherman, and both his father and his brother work in the industry. Described as an “expert crab fisherman”, Painter served as an engineer before working his way up and earning his own captaincy. When he achieved the rank, he became the youngest Captain in the fleet. He appeared on the second and third seasons of Deadliest Catch. The show filmed the drama and disappointment that Painter felt when he was not promoted in Season 2. When he made Captain in Season 3 it was a popular moment among fans. https://www.northpointrecovery.com/images/blog/wp-content/uploads/2018/06/Blake-Painter-Deadliest-Catch-Addiction-600×396.jpg
A Stressful and Dangerous Environment
“There’s no crying in crab fishing.” ~ Blake Painter There’s a reason why the program is named Deadliest Catch. It portrays vessels as they fish for crabs in the Bering Sea, off the Alaska Coast. Commercial fishing perennially ranks among the most hazardous occupations in the nation. But Alaskan crab fishing is even more dangerous—the fatality rate among crab fisherman is 80 times higher than the average US worker. In 2010, the National Transportation Safety Board held a forum on commercial fishing safety, reporting that fisherman must endure:
- Long absences from home
- Inhospitable environments
- Working with heavy, dangerous equipment while constantly in motion
- An extreme risk of hyperthermia, loss of women, or death
But commercial fishermen also face a tremendous amount of mental stress. In fact, a 2017 survey of Australian fishermen show that they have greater rates of psychological stress and a rate of depression that is approximately DOUBLE that of the general population. In addition to the loneliness and physical dangers, commercial fisherman often deal with economic instability – missed catch quotas, governmental regulations, and a downsizing fishing industry, for example.
The Link between Stress and Substance Abuse
The stress that Blake Painter must have dealt with daily is relevant because there is a scientifically-established link between stress and substance abuse. For example:
- In 2010, researchers at the Scripps Institute discovered that blocking the stress hormone also blocks the symptoms of alcohol addiction.
- A 2017 study published in Neuron suggests that exposure to acute stress causes specific neurons within the brain’s reward center to “flip” and incentivize substance consumption.
In a misguided attempt to alleviate stress, some people will try to “blow of steam” with alcohol or drugs.
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Near-Disasters: Occupational Hazards and Surviving a Terrible Wreck
Painter once described the regular accidents, injuries, and near disasters as “occupational hazards”. For example, he once narrowly avoided losing an arm to an ominous-sounding device known as “the crucifier”. In addition to regularly experiencing and witnessing accidents and injuries during the normal course of his dangerous workday, Blake Painter also nearly died on land. In June 2016, Painter was seriously injured when he crashed his pickup truck into a tree while towing a boat. His truck was completely totaled, and first responders had to use the Jaws of Life to remove him from the vehicle.
The Link between PTSD and Addiction
But surviving or merely witnessing such an event can be traumatizing and may result in painful or uncomfortable feelings that can be difficult to process. A person who has not learned healthy coping methods may “self-medicate” with alcohol or drugs in an attempt to ease emotional or physical pain. This is important because brand-new research just published in April 2018 found that recalling traumatic memories enhances the rewarding properties of opioid drugs. Researchers believe that these findings may help explain why PTSD and addiction co-occur so often. In Painter’s case, this new research is especially relevant, as will soon become evident.
Blake Painter’s Physically-Demanding Career Led to Painful Chronic Conditions
The life of a commercial crab fisherman is a hard one. First, there are the workplace injuries described by Painter, such as a hook through his hand or a finger slashed open “like a hot dog roll”. That second one was treated with tape, paper towels, and a glove. But as painful as that sounds, the real issue is how the rigors of his profession took a permanent toll on Painter’s body. Long hours and repetitive work meant that he needed surgery for carpal tunnel syndrome, and his back and shoulders were also giving him trouble. But most agonizing of all was a condition known as “the claw”. Painter woke up most mornings with his hands cramped shut and pain shooting up to his elbows. It is reasonable to assume that Blake Painter was prescribed painkillers for these issues.
The Link Between Pain and Addiction
Of special significance, a 2016 study by researchers at Columbia University Medical Center, people suffering moderate or severe pain have a 41% greater likelihood of developing a prescription painkiller addiction than those in lesser pain. Unfortunately, however, brand-new research just published in late-May 2018 by the National Institutes of Health found that chronic pain changes the brain’s ability to respond to opioid medications. In other words, prescription painkillers are not effective against chronic pain. Also significant, a March 2018 study revealed that opioid drugs are no better than over-the-counter remedies relieving chronic back, hip, or knee pain. Again, all of this research is especially relevant in the case of Blake Painter.
The Link Between Chronic Pain, Opioid Use, Depression, and Addiction
The same NIH study determined that chronic pain sufferers are more prone to depression. This is especially relevant because, in 2016, researchers at Saint Louis University identified a link between long-term opioid use and depression. There were two key points to these findings:
- First, this opioid/depression association is completely independent of pain-related depression.
- Second, the link was duration-dependent, not dose-dependent. As Dr. Jeffrey Scherrer, PhD, said, “Patients and practitioners should be aware that opioid analgesic use of longer than 30 days imposes risk of new-onset depression.”
Chronic pain plus long-term opioid use is the perfect recipe for depression, which then increases the likelihood of substance abuse. In fact, addiction and depression often co-occur, and having one disorder DOUBLES the risk of having the other.
Blake Painter and Heroin: A Hometown Bust
Most telling of all is Blake Painter’s arrest for heroin possession a few months ago, in January 2018. At 8:59 am on the morning of January 5, an Astoria police officer witnessed Painter smoking heroin while driving. Before he pulled over, Painter tried to hide the drug, but it was found during a search. He was charged with:
- Driving Under the Influence of intoxicants
- Unlawful possession of heroin
- Tampering with physical evidence
- Reckless driving
The Link between Prescription Drug Misuse and Heroin Addiction
According to the American Society of Addiction Medicine, 80% of heroin abusers started out by misusing their prescription opioid painkillers, which are themselves powerfully habit-forming. But because of the recent changes to prescribing guidelines, fewer painkillers are being given out. This means people who are painkiller-dependent become desperate and will go to almost any length to satisfy their cravings – faking symptoms, doctor shopping, obtaining pills from family members and friends, or even purchasing prescriptions illicitly from a dealer or over the Internet. But the economics of black market pain pills soon becomes a problem. For example, 20 mg OxyContin tablets can cost up to $80 apiece. But according to the Washington Post, a single dose of heroin costs about the same as a pack of cigarettes. This is precisely why 94% of people in treatment for opioid addiction self-reported switching to heroin because prescription painkillers were “far more expensive and harder to obtain”.
How Bad is the Heroin Problem in the United States?
Unfortunately, Blake Painter was not alone in his use of heroin. In fact, according to the Drug Enforcement Administration’s 2017 National Drug Threat Assessment, “Heroin poses a serious public health and safety threat to the United States.” Among the DEA’s 21 field operations offices, 11 of those reported heroin as the #1 drug threat, and an additional 6 ranked it #2. Additionally, 44% of the law enforcement agencies that responded to the 2017 National Drug Threat Survey said that heroin was the largest threat in their local area. In 2007, the percentage of agencies ranking heroin that high was just 8%. Just look at the overdose statistics:
- In 2012, there were “only” 5925 fatal heroin overdoses in America. But nearly every subsequent year saw a sharp increase.
- 2013: 8257 (+39%)
- 2014: 10,574 (+28%)
- 2015: 12,989 (+23%)
- 2016: 13,219 (+1.8%)
- And in 2017, there were 15,446 heroin-related overdose deaths.
- 2012-2017, that represents a 261% increase.
To give those numbers more perspective, while there are 10 times as many people who misuse prescription pain medications as there are heroin users, there only twice as many fatal overdoses. Heroin is so dangerous that 70% of users will overdose at least once during their lifetime and 1 out of 4 will overdose annually. Alarmingly, the Centers for Disease Control and Prevention estimates that the true number of overdose deaths involving heroin is significantly underreported and may, in fact, be up to 30% higher. Supporting this estimation is the fact that even though fewer painkillers are being prescribed, the number of opioid-related deaths continues to increase. Specific to Blake Painter’s situation, an analysis by the Oregon-Idaho High-Intensity Drug Trafficking Areas, heroin (along with methamphetamine) poses the greatest drug threat in the state of Oregon. https://www.northpointrecovery.com/images/blog/wp-content/uploads/2017/07/signs_someone_close_to_you_is_abusing_heroin.jpg
Counterfeit Drugs—The OTHER Opioid Problem
For people who purchase and use opioid drugs illicitly, there is another danger—counterfeit drugs. This is when another substance is mixed in with or even completely substituted for the expected heroin or illicit prescription. Most frequently recently, the substituted drug has been fentanyl, an extremely powerful synthetic opioid that is 50 times stronger than 100% pure, laboratory-grade heroin. Alarmingly, some analogues are up to 10,000 times more potent than morphine. At that strength, a fatal dose is measured in micrograms. In fact, an amount of fentanyl the size of six grains of salt is enough to kill a full-grown man. It so deadly that it may take several administrations of Narcan, the emergency medication used to reverse opioid overdoses. Illicit drug manufacturers and dealers substitute fentanyl for one of two reasons—(1) to boost the potency of the low-grade product, or (2) to save money. Heroin costs about three times as much to manufacture as laboratory-made fentanyl. But this switch is made completely without the end-user’s knowledge. And because the drugs appear identical, there is no easy way to tell the difference. So when a drug user consumes their “normal” dose of heroin that has been laced/replaced with fentanyl, an overdose is the tragic result. That’s not the only danger. Increasingly, powdered fentanyl is being pressed into pill form and purposefully mislabeled as an illicit prescription drug. US Customs and Border Control seized pill presses in 2017 at a rate that is 19 times higher than in 2011. This is exactly what killed music legend Prince in 2016. He unwittingly took what he thought was (illicit) Vicodin, but was in reality, a fatal dose of fentanyl. The death toll from synthetic opioids has risen by 540% within the last three years, and now claims more lives than heroin.
Why are Opioids So Addictive?
Whenever an opioid is used, the drug enters the bloodstream and travels to the brain. The method of consumption matters in terms of how quickly and strongly the effects are felt. For example, in the specific case of heroin:
- Intravenous Injection: This method produces the strongest effects, which are felt in 3 to 5 seconds.
- Smoking: Produces milder effects, typically felt in 5 to 15 seconds.
- Snorting: Gradual effects felt within 2 to 10 minutes.
- Intramuscular injection: Gradual onset, felt in 5 to 10 minutes.
- Oral: Produces the mildest effects, felt within 60 to 90 minutes.
The faster and more profoundly the effects are felt, the greater the risk of addiction. Once the drug reaches the brain, it binds to unique receptors in the brain and triggers a massive surge in dopamine production and release. Dopamine is the neurotransmitter associated with reward, pleasure, learning, and motivation. Usually, dopamine spikes are triggered by actions necessary for survival, such as eating or sex. When such an action is performed, the person is rewarded with pleasurable sensations. They soon learn to associate the reward with the action and are motivated to repeat it. Drugs of abuse mimic this mechanism but to a much greater degree. But over time, the body begins to build a tolerance to the drug, exhibiting a diminished response. This means the person needs to take larger and larger doses in order to experience the same effects. Eventually, this artificial over-stimulation of the brain’s reward pathways disrupts normal dopamine production, to the point that the user cannot experience pleasure of any sort—or even function normally—unless they are under the influence of the drug. Even worse, if the drug is discontinued, the person will experience harsh opioid withdrawal symptoms that are severe enough to trigger relapse. https://www.northpointrecovery.com/images/blog/wp-content/uploads/2018/06/confessions-of-a-heroin-junkie-600×259.jpg
Recognizing the Signs of Opioid Abuse and Addiction
Addiction is a progressive disease with noticeable warning signs, such as: Physical Signs of Abuse:
- Impaired coordination/clumsiness
- Extreme drowsiness
- Excessive sleeping
- Slurred or unintelligible speech
- Injection marks
- Unexplained burns on lips or fingers
Behavioral Signs of Abuse/Addiction:
- Loss of motivation
- Mood swings
- Exaggerating pain
- Asking/Buying/Stealing other people’s pain medications
- Visiting multiple doctors
- Ignoring family obligations
- Uncharacteristically-poor work or school performance
- Extreme anxiety, agitation, or depression when the drug isn’t available
Evidence of Abuse:
- Empty pill bottles
- Unmarked pills
- Multiple prescriptions for painkillers
- Possessing medications without a prescription
- Missing money
- Legal difficulties
The biggest sign of opioid addiction is the manifestation of withdrawal symptoms when the drug has been discontinued. These symptoms can begin in as few as 12 hours following the last dose. Symptoms include:
- Extreme anxiety
- Agitation and restlessness
- Inability to concentrate
- Irresistible drug cravings
- Hot and cold flashes
- Sexual dysfunction
- Uncontrollable yawning
- Extreme fatigue
- Muscle aches and cramps
- Spasms in the extremities—This is the origin of the term “kicking the habit”.
- Profuse sweating
- Flu-like symptoms
- Runny nose
- Watery eyes
- Nausea and vomiting
- Abdominal cramping and diarrhea
- Dilated pupils
- A skin-crawling feeling
- Very pronounced goosebumps– This is the origin of the term “cold turkey”, because the skin resembles a freshly-plucked bird.
The most frequent complaint of someone in is a general feeling of being completely ill, almost as if the sufferer has a severe cold or a bad case of the flu. This malaise is why opioid addicts in need of a fix will say they are “sick”.
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How Do Opioids Kill?
When opioid drugs arrive at the brain, they produce “positive” effects such as pain relief and a pleasurable “high”. But they are also central nervous system depressants that affect heart rate, blood pressure, and especially, breathing. Respiratory depression, or a slowed rate of breathing, is the biggest danger of opioid abuse. The average person will take between 12 and 20 breaths per minute. If the rate falls below that, then the person is not getting enough oxygen. They can pass out or even die. ALL OPIOIDS CAUSE RESPIRATORY DEPRESSION, even at prescribed levels. At higher, abuse-level dosages, the disruption of normal breathing can be deadly. Because a person experiencing a “normal” opioid high will frequently nod off and pass out, it can be tricky to recognize a true overdose emergency. To help, here are the warning signs of an opioid overdose:
- Blue fingertips or lips (seen in 20% of cases)
- Gasping, snoring or “gurgling” sounds – also called the “death rattle” (16%)
- Rigid muscles or seizures (13%)
- Confusion/Odd behavior before passing out (6%)
- Foam or excessive spittle coming from the mouth (6%)
- Skin discoloration: Light-skinned people will appear bluish-purple, while those with darker skins will look gray or ashy
- Slow and/or shallow breathing
- Extremely low blood pressure
- Weak, barely-detectable pulse
- Pinpointed pupils
- Clammy, cold skin
- Discolored tongue
- Vomiting, usually not completely successful. Their airway may be blocked.
- Unconsciousness, to the point of being unresponsive
There are two crucial things to remember about a suspected overdose of heroin or another opioid: FIRST, someone who is merely “extra-high” can still respond to strong external stimulus – being roughly shaken, hearing their name called loudly, painful pressure, etc. But an overdose victim is usually completely unresponsive. SECOND – and this is EXTREMELY important – opioid overdoses are somewhat gradual, and victims do not typically die immediately. Rather, it may take between 1 and 3 hours for the respiratory depression to reach fatal levels. In other words, there is still time to act and save their life.
Polydrug Abuse—Dangerous Opioid Interactions
The risk of overdose is greatly magnified when the drug is used in combination with other CNS depressants such as:
- Benzodiazepine tranquilizers (Xanax, Valium, Klonopin, Ativan, etc.)
- Barbiturate sedatives (Nembutal, Seconal, Luminal, etc.)
- Other opioids (Heroin, OxyContin, Vicodin, codeine, methadone, etc.)
Taking some combination of opioids, benzodiazepines, and alcohol is the most-common polydrug mixture and can result in serious health risks:
- 80% of drug poisoning deaths involving heroin, methadone, or buprenorphine also involve “benzos”.
- Opioid/benzo co-abuse TRIPLES the risk of psychiatric hospitalization.
- The likelihood of needing prescription medication for suicidal ideation is also DOUBLED.
- Between 2005 and 2011, there were almost 250,000 emergency room visits for opioid/benzo interactions
- There were also more than 43,000 ER trips were resulting from the simultaneous use of opioids, benzos, and alcohol.
- 37%-40% of those ER visits ended in a “serious outcome”—long-term disability, serious injury, coma, or death.
Responding to an Opioid Overdose
According to the Harm Reduction Coalition, there are specific steps to take when you suspect and opioid overdose poisoning. Your prompt actions at this time can mean the difference between life and death. First Step: Assess the situation and check for:
- Breathing – If they have stopped breathing, this is a medical emergency. Call 911 immediately and give rescue breaths until help arrives.
- Responsiveness—Call their name loudly, shake them, try to rouse them.
- Ability to speak—If they respond, talk to them and try to get them to wake up fully.
- Lip, fingertip, and skin color discoloration
If you get no response, try getting a reaction through direct pain stimulation:
- Rub your knuckles into their sternum HARD.
- Rub you knuckles HARD under their nose, across their upper lip.
When to Call 911
- They aren’t breathing.
- You are unable to rouse them in any way.
- They respond but complain of tightness in their chest.
After calling for an ambulance, move the person into the “recovery position” – on one side, with a knee bent in support. This position keeps their airway clear and prevents them from aspirating their own vomit. If an overdose reversal drug is available, administer it NOW.
Narcan—What You Need to Know
Narcan is the brand name for naloxone, an emergency drug that can rapidly reverse an opioid overdose and restore normal breathing. Naloxone medications act within 3 minutes, temporarily blocking the further absorption of all opioids for the next hour and a half. Even more significant, it pushes out any opioid molecules already bound to the brain’s receptors. This dislodging is what reverses the overdose. FYI, it also sends the victim into immediate and severe withdrawal. While not particularly dangerous, it can be very distressing for the revived victim. Narcan can counter every kind of opioid –
- Natural – codeine, opium, morphine
- Semi-synthetic – hydromorphone (Dilaudid), hydrocodone (Vicodin), oxycodone (OxyContin, Percocet, Percodan), buprenorphine, heroin
- Synthetic – fentanyl, carfentanil, Pink, U-47700, Gray Death
There ARE two important caveats, however. First, naloxone medications are not effective against every kind of overdose – tranquilizers or sedatives, for example. But keep this in mind—When in doubt, ALWAYS administer Narcan. If the cause IS an opioid, Narcan can reverse the overdose and possibly save the person’s life. And, if the overdosed drug is NOT an opioid, then Narcan will have no harmful effect whatsoever. Second, when more powerful opioids such as fentanyl or its analogues are the cause of the overdose, you may need to administer multiple doses of Narcan. Again, there is no danger in doing so. NARCAN SAVES LIVES. According to the CDC:
- 1996-mid-2014, more than 150,000 naloxone kits were given out to non-medical personnel.
- 81% of the kits were dispensed to drug users.
- As a result, over 26,000 overdoses were reversed.
- 83% of those overdose reversals were performed by drug users.
- In 82% of those overdoses, heroin was the cause.
Was Blake Painter an Addict?
As we consider all of these factors, we have to look at how they apply to the Deadliest Catch star. Specifically, we have to ask, “Was Blake Painter an addict?” Without an actual medical diagnosis, we can only rely on what we DO know about the disease of addiction and how so many risk factors were present in his life. And thf Using a term that refers to another famous tragedy in the commercial fishing world, Blake Painter experienced a perfect storm of factors that strongly point to addiction and overdose:
- Higher risk of depression
- Higher risk of PTSD
- Chronic pain
- Long-term painkiller use
- Heroin use
- Legal difficulties—not just the 2018 heroin bust, but also a 2013 DUI
But the most glaring sign of a problem comes from Painter’s own friends. In fact, his body was found by a concerned friend who had been unable to reach him for days. One of Painter’s costars on Deadliest Catch, himself a recovering addict who blames his disease on his dangerous profession of crab fishing, made two revealing tweets when the news broke: “A fellow fisherman has lost his life due to an overdose.” When asked who died, he replied, “A former crabber from the #deadliestcatch family.” Because of the timing and the circumstances, most people believe he is referring to Blake Painter.
Learning from Blake Painter’s Death
And if that is truly the case, then there are several important takeaways. FIRST, mental illness is to big a problem to ignore. People struggling with extreme stress, trauma, PTSD, depression, or other emotional issues need to know that they have resources other than self-medicating with alcohol or drugs. SECOND, effective pain management is key to curbing the opioid crisis. There are many other ways to manage pain – diet, exercise, physical therapy, massage, acupuncture, hypnosis, meditation, counseling… and many other options. Addictive opioid painkillers should only be prescribed as a “last resort”, and then, at the lowest dosage and for the shortest duration possible. Follow-ups and patient counseling should be frequent. THIRD, treatment should ALWAYS be an alternative to jail. Whenever someone is facing a DUI or drug charge, the Court should consider making drug rehab mandatory. FOURTH, NEVER ignore the warning signs. Addiction doesn’t happen in a vacuum – it affects everyone around that person as a terrible “open secret”. 1 in 20 Americans admits to knowing someone who abuses opioids. If that number includes you, then you need to do WHATEVER IT TAKES to convince them to get the help they need. In a very real way, you will be saving their life.