Prince and Why We Need More Compassion About Addiction

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A renowned Music Producer, Songwriter, Musician, Singer, Prince’s sudden death resonates a chilling and shocking surprise to many.  The death of Prince is painfully true and saddens those of us who followed him.

In memory of Prince, Dr. Lynn Webster recently posted THIS BLOG  on his Painful Truth website and was kind enough to repost it here as a guest blogger. We thank Dr. Webster for sharing this insightful message and keeping things in perspective.  Prince will be sorely missed by many music enthusiasts worldwide.

Here’s what Dr. Webster had to say…

We don’t yet know why Prince died. The facts aren’t in, and I don’t want to draw conclusions until I have more information.

That said, some entertainment media outlets (TMZVariety, and more) are reporting that Prince was treated with naloxone, which is the antidote for opioids including heroin, in the days before his death.

If that were true, it would mean that Prince was taking too much of a substance, whether it was prescribed or not.

But, if that turns out to be the case, it won’t change the fact that he was a musical icon, and it won’t change the fact that the world has lost an irreplaceable voice.

It won’t mitigate the loss of a superstar and a vibrant, innovative talent.

Here’s What Worries Me….

But here’s what worries me: in this age when the media reports information (or misinformation) as it comes in, the tide often turns against the individual who has inappropriately used drugs.

Learning that a celebrity died from an  addiction may change people’s perception of him or her, and it may diminish the tragedy of the death in the eyes of some who will rush to judgment. I’ve seen that happen too often when someone dies of an opioid overdose.

Here’s what I’d like for people to understand. If we find out that celebrities  — or anyone, for that matter – inadvertently overdosed on prescription medications or became addicted to heroin — we have to realize that they are still precious human beings.

Drug addiction doesn’t mean the person’s life is worth less than it otherwise would be.

Addiction isn’t a character flaw. It is a disease, and it’s a thief that can steal our friends, fathers, mothers, children, or — certainly — our beloved pop culture heroes from us.

We can miss Whitney Houston, and mourn the loss of Philip Seymour Hoffman, and want to bring back Cory Monteith, although their medical records and autopsy results may show us that addiction played a role in their deaths. We can love and honor our family members, neighbors, colleagues, and friends although they may suffer from addiction, too. In fact, it is our obligation to treat everyone with compassion and not to stigmatize someone with a disease, whatever that disease may be.

People with addiction are not letting us down or disappointing us when they use substances. They can’t control their addiction any more than they could be expected to control any other disease, whether it’s cancer, cardiac problems, or diabetes.

People With Addictions Have A Disease

People who live with addiction, or who die of addiction, aren’t doing anything wrong. We feel horrible when we lose an idol, a childhood friend, or anyone else, and that’s bad enough.

People with addiction need our understanding and appropriate medical treatment, not our disdain.

Now, if TMZ is correct, and Prince was treated with naloxone, here’s the issue: Naloxone (Narcan) works for only about 40 minutes. That’s enough time to save a life and buy time until an individual gets to a medical care facility where more naloxone can be administered or a person’s breathing can be supported.

If a person opts out of treatment because he/she is worried about the damage that might cause their reputation, then that just adds to the tragedy of the death. Immediate treatment can save someone from an overdose.

Lawmakers and Naloxone

Lawmakers may debate the rules that govern how people with opioid addictions should have access to naloxone. But moralizing about addiction doesn’t help people with addiction. We don’t add joy to our lives, and we don’t make the people who matter to us either healthier or happier, when we judge them for falling prey to the disease of addiction.

Maine Gov. Paul LePage recently vetoed a bill that would give people better access to naloxone. He said that it would only serve to allow the person an opportunity to overdose again. It is this attitude that contributes to the secrecy and deadliness of addiction.  This is like saying a person who has a heart attack should not be resuscitated by all available means, because it would only serve to allow the person the opportunity to have another heart attack.

This is clearly absurd.

No one should feel forced to deny the fact of their addiction in order to sustain a career, or to maintain the support of their loved ones. That’s just not the way it’s supposed to work. Death is hard enough. Attaching a stigma to the way someone we cared about died is just unworthy of us all.

We, as society members, must offer compassion to those with addiction. It’s within our power to support our loved ones when they struggle with addiction, and to honor them throughout the stages of their sickness.

Please feel free to share comments here or on Dr. Webster’s original post as linked above.

11 thoughts on “Prince and Why We Need More Compassion About Addiction

  1. We know now that he died of Fentanyl poisoning, and that the Fentanyl was pressed into tablets that were indistinguishable from Norco. I don’t think Prince was a drug addict at all.

    Why isn’t anyone discussing the probability that Prince suffered from untreated or undertreated pain? His entire life he has been anti-substance abuse and a teetotaler. He insisted that his bandmates, his entourage, his family and friends all not drink or do illicit drugs of any sort around him. In the early 2000s he became a Jehovah’s Witness, and took his religion very seriously. And then he decided now is the time to start recreational drug use and chasing a high? So very unlikely.

    I hope somehow the truth comes out one way or another. I believe that he thought he was taking pharmaceutical grade hydrocodone/apap to control pain in his damaged hip joints. I suspect his own doctors wouldn’t prescribe enough medication for pain control and he found another source, a friend or family member might have led him to believe he was getting their leftovers from an injury or surgery perhaps. That person may one day step forward, or law enforcement may one day track them down. I do wish we would get the whole story one day.

    I think Prince is a case study in pseudo-addiction. I also think that you will be seeing more and more pseudo-addicts, with people in chronic pain being cut back and cut off from opioids, the one thing that has given them any quality of life. They too may go to the streets for pain relief, but now they will be lumped in with addicts, even though they are seeking relief from pain, and not euphoria. And what of those who overdose on fake Norco or Percocet? They will be a statistic of drug addiction instead of a pain patient who got desperate, just like Prince is assumed now. And what of those who use the last bottle of their medicine to commit suicide? Again, they will add to the statistics of drug addiction, and again, even though they are simply desperate to escape pain, not trying to get high.

  2. Dr. Coleman and all,
    Looking from a global public health perspective, the burden of morbidity and mortality in this country is largely contributed to by tobacco and alcohol, more so than opioids. People choose to use tobacco and alcohol to their detriment and to the detriment of others.

    Another major health problem we have is obesity which some consider “self-inflicted” and that is causing much of the diabetes.

    Rather than encourage judgmental attitudes in health care professionals and foster more adversarial relationships between doctors and the patients they serve, I suggest we not sit in judgment of people who develop addiction disorders, or who become obese, or who don’t do daily exercises, or who don’t meditate or take their medication as prescribed.

    Rather it seems after 30 years of practice I’ve learned that I’m more likely to help people adopt healthier behaviors if I don’t hold a judgmental attitude. Motivational interviewing, health behavior coaching, using the palliative care framework of understanding the values and preferences of the patient, are some of the strategies that have enabled me to become more successful in my holistic pain medicine practices.

    Don’t think that I am naive about the dangers of misusing tobacco, alcohol, prescription medications and street drugs. I grew up and trained in the Bronx during the height of AIDS in the 1980s. I have seen all of the horrors of addiction up close.

    And I have also been brought pain patients who were on suicide watch. There is pain that is not compatible with life.

    Some of the most profound pain and suffering I have witnessed to date is in people who have developed addiction disorders.
    So I do agree that we must do everything we can to PREVENT addiction.

    I took an oath to relieve human pain and suffering.
    It is from a base of compassion that I try every day to accomplish that.

    1. Dear Dr. Weinstein: I understand what you are saying and agree in theory with your message, but I still think we can love the sinner while hating the sin. What triggered my remarks was Dr. Webster’s statement, “People who live with addiction, or who die of addiction, aren’t doing anything wrong.” That just struck me as being inherently wrong. This form of deference is not shown to any other preventable disease that I can think of. Do we not, for example, rightfully condemn smoking and excessive alcohol consumption? In doing so, we are not judging the people who smoke or drink excessively but, instead, their unhealthy behavior. This was my point, my only point, in disputing Dr. Webster’s statement. As you point out many of us have taken oaths to relieve human pain and suffering. Telling people that their behavior is wrong because the risk of addiction is high if they misuse or abuse drugs, in my opinion, is hardly judgmental of them as persons. Indeed, it may be construed as just one way of showing our compassion for them. I would think that the same might be said for advising people not to smoke, drink alcohol to excess, and to be sure to buckle their seatbelts while driving. That said, thank you very much for your thoughtful comments and best wishes.

  3. Societal opiophobia is deeply rooted in this country stemming back to the mid 1800s. I strongly recommend the excellent short book by Ahmad “The Opium Debate” for insight into the origins of this phenomenon that I have been studying. We have currently too much oversimplified the issues, distorting interpretations of data, and the singular focus on opioids is not serving us well. There are reasons to use a disease model approach to save the lives of people who fit the criteria for addiction disorders (whether substance use, gambling, electronic gaming, eating). I agree that more effort and resources should be allocated to prevention of these problems. I also think that a biopsychosocial approach is warranted, with growing poverty and the international drug trade being considered as contributing factors to solve the problems.

    I also believe that all too often people in pain are still being stigmatized and lack access to medical treatment that might include opioid medications because of a black reign of public and professional confusion.

    To reference my favorite musician who we know was lost using substances, it’s a purple haze that we need to clear up.

    1. Dr. Weinstein; Great to hear from you and I appreciate all the insightful comments! I would love for you to write a guest blog on the “the origins of this phenomenon”. It would be a great asset for blog followers here! If you’re interested, I’m at jeff@paindr.com to discuss.

  4. The state legislatures seem to believe that they know more about how much, many doses, strength of doses, and number of refills of pain medications better than the physician. Leave the prescribing of all medications (and the monitoring of the amount of medication being taken by a patient) to the doctors, especially if the RX is one that has been taken for an extended period of time, and no record of “self-medicating” has been noted by the prescribing physician via monitoring tests. If a patient isn’t having their medication levels monitored by a physician, the patient is responsible for the result. If the drugs being taken are illegal, such as Phillip Seymour Hoffman, only the user is responsible for their actions.

  5. With enormous respect and admiration for my dear friend Dr. Lynn Webster, I have to disagree with his analysis on several levels. There were more than 15,000 persons in the U.S. last year who died as a result of opioid overdoses. For most of these victims there will be no all-night block parties in their honor or wall-to-wall media coverage or meaningless panegyrics by politicians.
    Medical professionals have a right, indeed a duty, to define for us what a disease is, but in doing so, they should be specific in their definitions. All diseases do not have a common etiology, no more than they might be said to have a common remedy. Comparing the disease of drug addiction with cancer, cardiac problems, or diabetes is incorrect.
    To be sure, late-stage addiction has life-threatening risks similar to those of these other diseases. But mortality – if that be the most important similar risk – can hardly be used to suggest common causation. Disease states are not fungible, nor are their causes. Moreover, what good does it serve to say that someone who dies of drug addiction has not done anything wrong? Tell that to their parents, their kids, their brothers and sisters, their spouses, their friends and, yes, their fans.
    In the interest of wanting to sound politically correct, many of us have lost the ability to be judgmental, even when it comes to life and death issues like this. Why are we so hesitant to say that taking psychotropic drugs for nonmedical purposes is wrong? The nexus between drug abuse and crime, particularly crimes of violence like child abuse, spouse and elder abuse, is well-established. Incidentally, we find no such nexus between crime of any sort and cancer, cardiac problems, or diabetes.
    The first step in solving a problem is properly defining it. To misuse or abuse drugs is wrong. This must be said over and over and over again. Until we discover a real cure for the disease of drug addiction we must do our utmost to prevent it. This includes telling people the truth if they are contemplating misusing drugs or if they are misusing drugs, that yes, they are indeed doing something that is wrong and likely will lead to addiction and, possibly, death. When it comes to the disease of drug addiction, prevention is just as important as treatment and maybe more so.

  6. I would like to point out that he reportedly had chronic pain. Given the reports on his healthy/clean lifestyle the pain likely precipitated his addiction. I wonder when our physicians will make it a priority to understand 1) that chronic pain is debilitating and robs people of life 2) that it is the physicians responsibility to have a thorough knowledge of pain management OR refer to someone who does. And finally, interventional medicine does not equal pain management for many.

  7. Great blog, Jeff. The minute I heard of Prince’s death, I knew that the zealots would start babbling about the “likelihood” that opioids were involved. I pray that the toxicology comes back clean. Although their response will be that the samples were adulterated…..

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