The addiction that killed Prince.
Prince was a strict vegan, didn’t drink and frowned on recreational drugs, but his healthy lifestyle didn’t exclude prescription medication
WHEN he was on stage he could make magic happen and had audiences eating out of the palm of his hand. But Prince didn’t look anything like a world-famous pop star as he paced restlessly outside a pharmacy near his home in Minnesota, USA.
Staff at Walgreens were used to seeing the Purple Rain superstar in their store but on this occasion in May something seemed wrong. He looked “frail” and “nervous”, they say. Dressed from head to toe in black, he was so strung-out that he could hardly stand still and asked that his medication be brought to him outside in the parking lot.
It was in fact the fourth time he’d been there that week. And it would be the last.
Less than 24 hours later Prince (57) was found dead in an elevator at his Paisley Park mansion (YOU, 5 May) just a short distance from the pharmacy.
Now everyone is asking: what medication was he collecting that day and was this what killed him? Autopsy results have revealed that Prince died from an accidental overdose of fentanyl, an opioid painkiller that can be up to 50 times more potent than pharmaceutical grade heroin.
It seems his high-octane stage performances which won him a legion of fans took a heavy toll on his body – all those occasions where the seven-times Grammy winner wowed audiences by doing the splits and leaping from heights in high platform shoes left him nursing a chronic hip injury.
“He was in pain all the time, but he was a performer,” says his former fiancée, singer Sheila E.
Prince had reportedly been taking medication for a while to help him cope with the pain and the theory is that, like other big- name stars such as Michael Jackson and Heath Ledger, he got hooked.
But what makes his case so poignant is he knew that he was in trouble. Desperate to avoid becoming another tragic celebrity statistic, he reached out for help. Sadly, it arrived too late.
Six days before his death, warning bells were already starting to ring when it was reported that he’d lost consciousness on his private jet while travelling home from a concert in Atlanta. The pilot had to make an emergency landing in Moline, Illinois. At the time his publicist said he was being treated for a bad case of flu but it has since come to light that medical staff administered Narcan, a drug used to counteract the effects of an opioid overdose.
After being discharged he was referred to Dr Howard Kornfeld, a California doctor who specialises in addiction. On 20 April the doctor was due to meet the
star at his home for a consultation but when the day arrived Kornfeld couldn’t make the appointment. So he sent his son, Andrew, in his place. Although not a doctor, Andrew works at his dad’s clinic and when he boarded an early morning flight to Minnesota, he was carrying in his bags a drug used to treat opioid addiction which his father hoped would help break Prince’s habit.
When he arrived at the singer’s home he and two members of the household staff found Prince’s lifeless body.
Now investigators are trying to join the dots. There are strict regulations regarding fentanyl and they’re trying to figure out who gave him this potentially lethal drug and why.
TO MANY of his friends the news of his overdose came as a big surprise. As a strict Jehovah’s Witness, Prince went out of his way to follow a healthy lifestyle. He was a committed vegan – to the point where he wouldn’t even allow meat in his house – didn’t drink alcohol and frowned on the use of recreational drugs.
As his hip condition worsened he underwent surgery in the mid-2000s but it didn’t completely alleviate the problem. Going onstage last year at the Golden Globes to present an award, he clutched a stylish silver cane.
Was he already in the grip of painkiller addiction? Prince was secretive about his private life and enjoyed his solitude – often to the point of being reclusive. Friends say that if he was taking drugs there were no signs of it. If only there had been. Then perhaps somebody might have been able to help him. Now his name has joined a line-up of talented stars who died long before their time. Michael Jackson (50): News of the King of Pop’s death sent shockwaves around the world in 2009. Autopsy results showed he’d died of acute propofol and benzodiazepine intoxication at his Los Angeles home. Propofol is a powerful anaesthetic used in hospitals while benzodiazepine is a class of drug, mainly used to treat anxiety. Heath Ledger (28): Abuse of prescription painkillers also cost the talented Brokeback Mountain star his life. He was found dead in his New York apartment in 2008 after accidentally overdosing on a cocktail of six painkillers and sedatives, including oxycodone (Percocet), the same class of painkiller that Prince was reportedly taking at the time of his death. Anna Nicole Smith (39): The former Playboy centrefold and heiress was found dead in a hotel room in Florida in 2007 after accidentally overdosing by combining a sedative drug with four kinds of benzodiazepines. Her son, Daniel (20), had also died of a prescription drug overdose a year earlier.
What is fentanyl?
It’s often used for pain relief in cancer treatment worldwide, including in South Africa, and can be up to 100 times more potent than morphine. Fentanyl is also sometimes used to treat patients who have built up a tolerance to other pain drugs – which might have been the problem in Prince’s case. It can be consumed in a variety of ways, including through patches, injections, smoking and a lollipop, but what makes it dangerous is that its effects don’t last long so users are more likely to use it more frequently, increasing the risk of overdose.
Dr Cindy Stephen, director of the Poisons Information Centre at the Red Cross War Memorial Children’s Hospital in Cape Town says to her knowledge fentanyl is only available in South Africa as a transdermal patch or an intravenous injection (used in anaesthetics and surgery).
It falls into the opioid category of prescription drugs along with codeine, hydrocodone, oxycodone (Percocet), hydromorphone, meperidine and morphine. Unlike other pain relief drugs such as paracetamol and non-steroidal anti-inflammatory drugs such as ibuprofen and aspirin, these medications are addictive. They are commonly abused because they increase the levels of the hormone dopamine in the brain, causing a sense of euphoria.
In the US it’s the second- most abused drug after marijuana (dagga).
What are the signs of addiction?
A dependence on prescription medication can often be spotted on medical records, which would illustrate how often the particular medication is taken, says medical doctor Dr Gregory Hanslo from Uitenhage.
If pharmacists suspect something’s amiss they usually follow up with the prescribing doctors first. Alarm bells should ring when the person becomes agitated, continuously claims they need it for pain or fabricate the reasons for acquiring the medication, Dr Hanslo adds.
“When the person abruptly stops taking the pills they might start to shiver, sweat, become irritable, dizzy and more anxious than before.”
“You’ll immediately notice it in their appearance,” says Dy Williams, PR and social media liaison for Houghton House Addiction Recovery Centres in Johannesburg. She says that tell-tale signs are often sweating, insomnia and antisocial behaviour.
How can family and friends help?
“The first thing to do is to schedule an intervention and get the individual to be assessed at a rehabilitation centre,” Williams says. But she warns that ultimately real change only happens once addicts choose to help themselves. “Relapse is common if an addiction isn’t taken care of. Like with any addiction, recovery comes with terrible withdrawals and if you don’t have proper support for your addiction, relapses happen.”