As of 2017, fentanyl was the most widely used synthetic opioid in medicine. Listed as a DEA Schedule II controlled drug, Fentanyl is often prescribed for persons with moderate to severe chronic pain. It is also used as anesthesia for open-heart surgery, for those already physically tolerant to opiates such as morphine, and prescribed for cancer treatment. Fentanyl can be made illicitly and has contributed to a sharp spike in overdose deaths in the United States. The Centers for Disease Control and Prevention (CDC) estimated that of the more than 64,000 US overdose deaths in 2016, more than 20,000 were attributed to synthetic opioids, many of them related to fentanyl and its variations. Musicians Prince and Tom Petty are among the most recognizable of those caught up in the drug’s narcotic sway.
Prince Rogers Nelson
Prince was 57 when he was found unresponsive at his Paisley Park estate in Chanhassen, Minnesota. After his death on April 21, 2016, data revealed he died of an “exceedingly high” concentration of fentanyl. The concentration of fentanyl in his blood was 67.8 micrograms per liter, and fatalities have been documented in people with blood levels ranging from three to 58 micrograms per liter.
After Prince’s death, search warrants identified pills, including fentanyl and other drugs, in disguised containers. Some were concealed in OTC medications like vitamin and aspirin bottles. Prince was able to keep his use of opioid painkillers hidden because the artist did not have prescriptions for them. In one affidavit, a doctor admits to prescribing Prince oxycodone, just a week before his death, but the prescription was made in the name of Prince’s friend for “privacy.”
The diminutive superstar weighed 112 pounds and was 5’ 3” tall when he died. Plagued with drug addiction for years, Prince had to be revived from an overdose just before his death. He had been warned to stop taking painkillers, but the multi-talented artist said his hands hurt so much that if he quit, he’d have to stop performing.
Prince wrote and produced music for five decades. The theme song “Purple Rain” won an Academy Award for best original score, and the album was later awarded the Grammy Hall of Fame award. Prince won three Grammy’s for songs on the album and his “When Doves Cry” was nominated for a Golden Globe. He earned 32 Grammy nominations and won seven Grammy’s during his career. He was inducted into the Rock and Roll Hall of Fame on March 15, 2004.
Another Hall of Fame musician, Tom Petty, 66, also died of an accidental drug overdose. He was found unconscious and not breathing at his Malibu home. He was rushed to a hospital where he was placed on life support. Although he had a pulse, doctors found no brain activity and the decision was made to pull life support. He died hours later on October 2, 2017.
Petty’s death was caused by taking too much of the pain killing narcotics that he was legally prescribed. The Los Angeles County Medical Examiner said that the musician had taken several pain medications, including Fentanyl, Oxycodone and generic Xanax. Other medications included generic Restoril (a sleep aid) and generic Celexa (which treats depression).
The official cause of death was listed as “multisystem organ failure due to resuscitated cardiopulmonary arrest due to mixed drug toxicity,” noting the singer suffered from coronary artery atherosclerosis and emphysema. Petty had been prescribed the drugs to treat emphysema, knee issues and a fractured hip, issues that persisted throughout his final 40th Anniversary Tour.
Petty’s wife Dana and daughter Adria wrote in a public statement:
Despite this painful injury, he insisted on keeping his commitment to his fans and he toured for 53 dates with a fractured hip and, as he did, it worsened to a more serious injury. On the day he died, he was informed his hip had graduated to a full-on break and it is our feeling that the pain was simply unbearable and was the cause for his overuse of medication.
Petty’s family hopes that the musician’s death leads to a broader understanding of the opioid crisis. “Many people who overdose begin with a legitimate injury or simply do not understand the potency and deadly nature of these medications.” Both Prince and Tom Petty were victimized by fame and physical pain. Associates of Prince said that the artist was in constant pain near the end of his life, from years of performing, which may have been the initial reason for opioid use.
Tom Petty and the Heartbreakers sold more than 80 million records and were inducted into the Rock and Roll Hall of Fame in 2002. He was laid to rest on October 16th at a private service in Pacific Palisades, California.
Both legal and illegal Fentanyl use has been steadily increasing over the past two decades. Fentanyl prescriptions more than doubled from 2.59 million in 2000 to 7.64 million in 2008. The U.S. Department of Justice says the availability of fentanyl is due to the increase of legal prescriptions in many forms. Because of its rapid effects, U.S. medics in Afghanistan pack fentanyl lollipops in their kits to administer to critically wounded soldiers. In June 2011, the U.S. Food and Drug Administration approved the fentanyl nasal spray, Lazanda, a schedule-II controlled substance for patients who are opioid-tolerant and already receiving opioids for persistent cancer pain.
Fentanyl is often administered through a transdermal patch that can last for two or three days. But patients who experience extreme pain often assume that they can use more patches than recommended. Doing so, however, puts the patient at risk of respiratory distress and possible fatal overdose.
First national tally
On the street, the addition of fentanyl to increase heroin’s potency has become a common practice in a growing and competitive market. As documented on Top Cops’ “The China White Episode” of 1988 killed 18 people and caused over 200 overdoses. Again, in 1991, over 126 east coast deaths were attributed to China White, the street version of 3-methyl fentanyl. One of the largest numbers of fentanyl-heroin deaths occurred from April 4, 2005 to March 28, 2007. In the first national tally of the fentanyl deaths, the CDC reported in July 2008, 1,013 victims. Among the 984 decedents whose sex and age were known, 577 (58.6 percent) were aged 35–54 years and 788 (80.1 percent) were male. Among the 984 decedents whose race/ethnicity were known, 545 (55.4 percent) were white, 392 (39.8 percent) were black and 41 (4.2 percent) were Hispanic.
According to the CDC:
Most recent cases of fentanyl-related harm, overdose, and death in the U.S. are linked to illegally made fentanyl. It is sold through illegal drug markets for its heroin-like effect. It is often mixed with heroin and/or cocaine as a combination product—with or without the user’s knowledge—to increase its euphoric effects.
In 2015, United States border agents seized approximately 200 pounds of fentanyl among other synthetic opioids. In comparison, in 2014 they seized around 8 pounds. Authorities believe the fentanyl-heroin mix is a bizarre marketing tactic to gain a competitive advantage. The fentanyl-heroin mix presents a difficult challenge for addiction professionals, as many hardcore addicts actively seek out the drug, ignoring fears of a potential overdose, in hopes of a powerful new high.
That high often leads to death. Fentanyl, when combined with heroin’s suppression of the central nervous system, triggers irregular heartbeat, breathing difficulty, and horrific feelings of suffocation. Systematically, the drug slows and then, for some, stops the beating of the heart. Death comes, not in a violent bloodstained spasm, but in a shroud of dark, eternal sleep, like that suffered by musicians Prince and Tom Petty. May their music and legacy live forever and may their deaths provide us hopeful insight into ending this terrible national tragedy.
Maxim W. Furek has a rich background that includes aspects of psychology, addictions, mental health and music journalism. His book The Death Proclamation of Generation X: A Self-Fulfilling Prophesy of Goth, Grunge and Heroin explores the dark marriage between grunge music and the beginning of the opioid crisis.