A Hidden Addiction: Prince’s Overdose on the Opioid Fentanyl

"The plan was to quickly evaluate his health and devise a treatment plan. The doctor was planning on a life-saving mission."
~Attorney William Mauzy, speaking of the intervention that was planned for Prince before he died.

On April 21 of this year, the legendary musical superstar Prince Rogers Nelsonknown eponymously by his first name - was found dead at his Minnesota estate. He was only 57.

To most of the world, the death of Prince at such a relatively young age was completely unexpected. The diminutive performer had a reputation for living an extremely clean lifestyle - vegan meals, no alcohol, and no drugs.

But even before the medical examiner's autopsy report revealed that Prince died from a self-administered accidental overdose of the powerful synthetic opioid painkiller fentanyl, stories began to surface that painted an altogether different picture - one that was at odds with the public's perception of the singer's supposedly Spartan aesthetic.

Despite - or perhaps because of - his penchant for energetic stage performances, Prince lived with debilitating hip and knee pain, and the one thing he found to help him manage it ultimately took his life.

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Opioid Addiction in the United States

Opioid Addiction in the United States

Opioid drugs are medications that are typically used to relieve pain. They’re only available by prescription, unless you’re using illegal opioids such as heroin or opium. These have been found to have no medicinal value in the United States.

Sometimes people continue to take opioid drugs for a long period of time. They are quite effective, and people have a hard time stopping them once they start. They change how the brain responds to pain by lowering the number of pain signals from the body.

An opioid addiction can result from: 

  • Taking one of these medications for too long
  • Taking doses that are much too high
  • Taking these drugs in a way that is contrary to the prescription
  • Taking medications that are prescribed for someone else
  • Mixing an opiate drug with another drug, or with alcohol 

Once you’re addicted to opioid drugs, you have a disease of the brain. Whereas you may have had a choice in using at one time, that choice no longer exists. You effectively become a slave to the addiction. You can’t help but want to keep using them, and this is coupled by powerful urges to do so. 

Fentanyl is one of the more powerful (and popular) opioid drugs. It is highly effective at treating pain when other methods of treatment have failed. It doesn’t take long to form an addiction to this drug.

Opioid Addiction Treatment

Opioid Addiction Treatment

Today, we are very fortunate to have so many great options for treating opioid addiction. Most people will begin during a period of opiate detox. This is a way of allowing the body to adjust to no longer having the drug. Stopping the use of opioid drugs will result in withdrawal symptoms, and detoxification can help. Usually, the individual’s dosage of opioids will be tapered down during this process. This further minimizes the severity of withdrawal.

Opioid treatment in the United States frequently involves the use of medications. This is known as Medication Assisted Treatment, or MAT. For someone receiving MAT, they are given one of several different opioid replacement drugs. Some of these include:

  • Buprenorphine
  • Suboxone
  • Subutex
  • Methadone
  • Butrans

These medications block the opioid receptors in the body. They help with withdrawal symptoms and they can also make other opiate drugs ineffective.

While these medications are a wonderful addition to opioid treatment, they must not be misused. In some cases, they themselves can be addictive. They should always be used in conjunction with an excellent opioid rehab program. This is because an opioid addiction is more than just physical; it is also psychological.

During rehab, patients receive different types of therapy, based on their needs. The goal is not just to get them to stop using. Instead, the goal is to get to the source of the problem. This could be anything from having a mental health condition to just suffering from large amounts of stress.

Although opioid treatment is important, ongoing care for addiction is vital. People have to commit to getting treatment long-term. If they don’t, they are much more likely to relapse.

Opioid Abuse in the U.S.

Most people begin using opioid drugs because they received a prescription for them. They may have known that they were addictive, but they didn’t necessarily believe it.

Prince’s Overdose on Fentanyl

These individuals may have used these drugs for quite some time. Eventually, they probably noticed they weren’t working as well as they once did. In an effort to improve their effectiveness, they upped their dosage. This is usually the first step in abusing any type of drug.

When someone abuses a drug long enough, that abuse will eventually become an addiction. According to the National Institute on Drug Abuse:

  • As many as 36 million people currently use opioid drugs all over the world.
  • Of that number, 2.1 million of them are from the United States.
  • The number of unintentional overdoses from opioid drugs has increased four-fold since 1999.
  • Evidence suggests that there is a link between opioid abuse and heroin addiction in the U.S.
  • In 1991, there were 76 million prescriptions written for opioid drugs.
  • By 2013, there were close to 207 prescriptions written for these medications.

It’s amazing to see how much the use of these drugs has grown even over the last few decades. If the experts are correct, this is a problem that’s only going to get much worse.

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The Opioid Epidemic and Statistics

It’s clear that our country is facing an opioid epidemic. Every year, the problem escalates more and more. The statistics even support this fact. According to the American Society of Addiction Medicine:

  • In 2015, there were 20.5 million people in the U.S. with a substance abuse disorder.
  • Of these individuals, 2 million of them had a problem involving prescribed pain relievers.
  • Close to 600,000 of them had a substance abuse disorder that involved heroin.
  • Research has shown that opioid addiction and heroin addiction are connected to one another.
  • The leading cause of accidental death in the United States is accidental overdose.
  • In 2015, there were more than 52,000 lethal drug overdoses in our country.
  • Of these, more than 20,000 of them were related to prescribed opiate drugs.
  • Sales of prescription drugs were four times what they were in 1999 in 2010.
  • From 1999 to 2009, six times more people received treatment for substance abuse disorders.

It appears that more people than ever are seeking help for their addictions. However, that doesn’t do much to help the pain of losing one of the best-loved musicians in the world. The loss of Prince was something that shook our country to the core. It hurts to know that he’s gone, and it’s hurts even more to know that it could have been prevented.

Like millions of Americans, Prince had a secret - he was abusing prescription pain medication.

Warning Signs and an Intervention Too Late

Warning Signs and an Intervention Too Late

Prince lived an intensely independent-yet-private lifestyle that may have contributed to his ability to keep the secret of his prescription misuse from everyone except those closest to him.

In the last month or so before he died, Prince's inner circle began to see signs of a problem - he was eating less, losing a significant amount of weight, and complained of being sick "weeks at a time". At the time of his death, Prince only weighed 112 pounds.

Then there was the matter of the plane that had to make an emergency landing because Prince was suffering from what was reported at the time as "flu-like symptoms". Subsequent accounts reveal that Prince actually overdosed on Percocet - yet another prescription opioid painkiller - and had to be revived with a life-saving overdose antidote "save shot".

Friends were worried enough for Prince's health that they contacted Dr. Howard Kornfeld, a prominent addiction treatment specialist. Dr. Kornfeld scheduled a visit at Prince's home for April 22. The plan was to do an intervention.

As it turns out, that was one day too late. In fact, help may have even been minutes too late.

Dr. Kornfeld's son Andrew, who works with his father, arrived at Prince's Paisley Park estate at 9:30 AM on the morning of the 21st. At first, the singer could not be located, but minutes later, they found him unresponsive in an elevator.

Andrew Kornfeld, who had just arrived to start the evaluation process, was the one who had to make the 911 call. Because he was unfamiliar with the address, he simply told the dispatcher, "We're at Prince's house."

What You Need to Know about Fentanyl

What You Need to Know about Fentanyl - the Drug That Killed Prince

Fentanyl is a synthetic opioid medication that is prescribed to help patients suffering with severe, acute pain. Like other opioids, it does not truly "block" the pain. Rather, what it does is changes the patients' perception of that pain, and as a side effect, can induce a euphoric state of relaxation and well-being. This is why opioids are such popular drugs of abuse.

Fentanyl is extremely potent - it is up to 100 times more powerful than morphine, and 30-50 times stronger than pharmaceutical-grade heroin of 100% purity.

What Makes Fentanyl So Dangerous?

As with other powerful opioids, a fentanyl overdose can be caused due to respiratory arrest/depression - when the patient's breathing slows or altogether stops. This is why opioids are particularly dangerous for someone who already has a breathing condition, such as asthma.

Opioids can also induce vomiting, so it is not unheard of for a person who mixes alcohol and fentanyl to choke to death on their own vomit.

Over time, a person who misuses opioids develops a tolerance - more and more of the drug is needed to achieve the same effect. Having to take ever-increasing amounts of such a powerful drug is one of the main causes of fatal overdoses.

When fentanyl is acquired illegally, it is frequently "cut"- mixed in - with other illicit drugs such as cocaine or heroin, amplifying the effects of each and greatly increasing the hazard. This is usually done without the user's knowledge, and there is no way to tell.

Between late 2013 and all of 2014, there were over 700 fentanyl-related overdoses reported to the Drug Enforcement Administration.

Deaths Due to Prescription Opioid Painkillers Continue to Rise in America

Unfortunately, the death of Prince is only symptomatic of a larger and still-growing problem in the United States.

According to the 2014 Centers for Disease Control and Prevention National Survey on Drug Use and Health:

  • In 2014 - for the first time ever- drug deaths are the largest cause of accidental deaths in the US.
  • The number of drug deaths hit an all-time high - over 47,000
  • This is over 50% greaterthan the number of deaths due to automobile accidents.
  • This is a year-over-year increase of 14%from 2013.
  • Opioids are involved in over 60%of all overdose deaths. Opioids are the class of drugs that include hydrocodone (Vicodin), oxycodone (Percocet and OxyContin), fentanyl, and heroin, among others.
  • Since the year 2000, the number of fatal opioid overdoses has risen by 200%.
  • Every month, almost 4-and-a-half MILLIONAmericans use a prescription painkiller non-medically.
  • Almost TWO MILLIONAmericans currently meet the criteria for a diagnosis of an Opioid Abuse Disorder.
  • More than 50%of individuals who misuse prescription opioids were given them by a friend or relative.
  • Another 25%of prescription painkiller abusers get them from their doctor.
  • Another class of drugs, benzodiazepines - which include alprazolam (Xanax), diazepam (Valium)clonazepam (Klonopin), and lorazepam (Ativan)- is responsible for roughly one-third of the almost 23,000 prescription overdose deaths in 2013.
  • This works out to more than 7000fatalities in America.
  • Approximately 75%of all benzodiazepines-related deaths also involved some type of opioid.

What Can We Learn about the Fentanyl-Related Death of Prince?

If there is anything that we need to understand from this tragedy, it is this inescapable fact - ANYONE can struggle with substance abuse. Even though he was rich, famous, and adored by the public, Prince had the same human frailties as the rest of us -

  • He suffered chronic pain that he was unable to manage
  • He misused improperly-yet legally prescription painkillers
  • He became dependent upon them
  • Addiction took his life

But perhaps the biggest lesson we can all learn and use in our own lives is that you can never ignore the telltale warning signs of prescription medication misuse, dependence, abuse, and addiction. Help was on the way, but in Prince's case, it came one day too late.

Timely Interventions And Effective Substance Abuse Treatment Can And Will Save Lives

Timely Interventions And Effective Substance Abuse Treatment Can And Will Save Lives

If you or someone you care about is struggling with prescription medication abuse, dependency, or addiction - whether to opioid painkillers or benzodiazepines - you can get the immediate help you need by contacting Northpoint Recovery today. Please don’t put it off. If you do, it may eventually become too late for you to get the help you need.

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Prince Overdose on Fentanyl