I have followed news of Prince’s death this spring with a mix of anger and insight. While the cause is still under investigation, officials suspect prescription drugs played a role; authorities found opioid medication on him when he died and in his Minnesota home.
From my experience as a doctor specializing in treating those addicted to such pain medications, I believe it likely he was taking more and more of these medications because of withdrawal symptoms until he overdosed and died. I hope his death inspires people to look at how we treat those with addictions, as much as his music inspired them in life.
Most people – even some treatment professionals – continue to believe the myth that addiction is self-inflicted and that “counseling” is an effective treatment. The reality is that people develop tolerance to pain medications, become dependent, have intolerable withdrawal symptoms and eventually take higher doses, even if they start off taking medications as directed.
Thus, physiology and biochemistry – not a moral failing – cause people to take prescribed pain medications to the point the opioids cause terrible withdrawal symptoms if not taken.
Medical science has shown one of the brain’s constant goals is to try to maintain a chemical balance. When a high tolerance occurs because of frequent use, and when drug use stops, the sudden, sharp drop in neurotransmitter levels upsets the chemical balance. The brain activates a deep, instinctive drive to get more drugs and restore the higher neurotransmitter levels the brain is now used to having. The brain works against the will of the person because the brain is deprived of something it thinks it needs to survive, and the brain’s only goal becomes to obtain that substance again.
Still, society treats those who use opioid pain medications as personal failures.
Even many common treatments, such as 12-step programs, emphasize that addiction can be treated by relying on a “higher power” instead of treating it like the medical illness it is.
It is comforting for us to believe that after people cease use of an addictive drug, their brain returns to its natural balance. If this were true, simple detoxification would work. Unfortunately, medical professionals know this is not always the case.
With our new understanding of the disease of addiction, we have been able to develop some medications, such as buprenorphine, which can get at the root of the medical problem, at the neurochemical level. These medications offer us a true chance to treat and beat the disease of addiction. However, because of the myths, stigma and lack of proper medical resources, that treatment can be hard for people in need to seek out and to find.
An attorney for drug-addiction consultant Andrew Kornfeld told reporters he had plans to meet with Prince to encourage the entertainer to enter rehab and begin treatment with buprenorphine, but he was too late.
If Prince, a wealthy and influential person, had difficulty getting proper treatment in time, or felt it necessary to hide his struggles, think how difficult it must be for people whose disease has already deprived them of financial and other resources to get help. Addiction treatment needs to be accessible just like treatment for other common diseases.
For Prince, the medicine that might have saved his life was too slow in coming. For those still living with addiction and the medical professionals who treat them, it does not have to be. We must start an honest conversation about treating addiction before more senseless deaths occur.
Dr. Lee Tannenbaum founded the Bel Air Center for Addictions in Maryland. Email: Baca@baca.comcastbiz.net