Archive for the ‘Overdose’ Category

princeone

Prince Rogers Nelson had mad hips. They shimmied, swiveled and shook. Prince’s hips promised purplelicious “lovesexy.” They seduced generations. But after decades of dancing in high heel boots, jumping off of stage speakers and risers and landing in splits, Prince’s hips betrayed him. He suffered incapacitating pain. “There wasn’t a tour we did where he wasn’t sometimes performing in pain,” said Alan Leeds, Prince’s former tour manager in the 1980s. The musician Sheila E. who collaborated with Prince said, “He was in pain all the time, but he was a performer.” We don’t know when Prince became dependent on opiates but an alleged drug dealer to the star said he sold him Dilaudid and fentanyl in 1984. In 2010, Prince had a hip operation. After the surgery he continued to use a cocktail of narcotics to cope with pain.

Chronic pain sucks. It is not sexy. It is embarrassing. It is isolating. It is humbling. Prince must have cycled through all these emotions and he probably cried because the pain was so bad. People with chronic pain in America have to keep secrets and tell lies. It’s the stigma and the real possibility that you’ll be denied access to pain medication. Prince was no exception – he kept secrets and told lies about his drug use.

This is what it sounds like

When doves cry

 Untreated, chronic pain destroys creativity. Prince had to medicate the pain to continue creating music. It was his life, his gift, and his obsession. He said in an interview in 2004, “Music is everything to me. I love making music. I am making music. Music is spirit, it’s therapy…” And control of his music was nonnegotiable. Prince waged a public fight with Warner Bros. for the rights to his songs and famously wrote ‘slave’ on his face. He told Rolling Stone magazine, “People think I’m a crazy fool for writing ‘slave’ on my face. But if I can’t do what I want to do, what am I? When you stop a man from dreaming, he becomes a slave…” Prince couldn’t allow pain to stop him from dreaming. No way.

It’s tragic that in providing so much pleasure for his fans he lived with so much pain. But Prince had the resources and savvy to manage his discomfort. With his enormous wealth, power and prestige, he was able to get prescription narcotics from physicians and buy them on the black market. Safely ensconced in his Paisley Park estate behind high, black chain mail fences with signs that declared, “WARNING PRIVATE PROPERTY UNDER 24 HOUR DIGITAL SURVEILLANCE,” Prince didn’t have to fear a police raid or an arrest for possession of a controlled substance without a prescription. Everyone who entered the compound surrendered cell phones, cameras and video recorders. No compromising film or photos of Prince would surface on social media. The artist had a small, loyal staff and burly security guards dedicated to ensuring his privacy. Prince always chartered private jets to travel. His carefully curated and reclusive lifestyle allowed him to use narcotics freely and fly under the radar of the drug warriors who want to punish and incarcerate illicit pain pill users.

Prince was “anti-drug.” His belief in abstinence was grounded in moralism and religion. He was a Jehovah’s Witness. Prince was portrayed in the media as living a “clean” lifestyle. If you used drugs, one person who knew Prince said, “you weren’t going to work with him. You didn’t have a job.” At concerts and after-show parties at Paisley Park, much to the chagrin of fans and fellow artists, no alcohol was ever served – just Red Bull, Coca-Cola, juices and water.

Stanton Peele wrote a piece about Prince’s overdose death that argued, “Being “anti-drug”—meaning anti-recreational drug use—is no guarantee that a person won’t overuse meds in dangerous and addictive ways (think Elvis, Michael Jackson and Rush Limbaugh.) Indeed, this strangely ambivalent attitude towards drugs might itself be considered a specific causative risk factor in dangerous drug use and negative drug outcomes, one that hinders sensible and safe drug use.” Peele’s point applies to Prince. Prince’s position on drugs was contradictory. He was a drug user who purchased opiates illegally, which in some states is a felony crime, and at the same time he denounced those who did the same thing. Prince probably never thought of himself as a “dope fiend” or an “addict,” that was other people. But how did Prince justify his illicit use of narcotics? Probably by believing he took them to medicate pain, not recreationally to get high. But odds are Prince experienced euphoria. And I bet he liked that feeling.

This is what it sounds like

When doves cry

Prince overdosed on a plane returning from a concert in Atlanta. After an emergency landing, paramedics revived him on the tarmac with a shot of naloxone. Here is an example of what Peele means about how an ambivalent attitude toward drugs “hinders safe and sensible drug use.” If Prince were honest about his opiate use, his trusted staff would have been trained to use naloxone and overdose prevention kits would have been on the plane and at his home.

The brush with death must have shattered Prince’s confidence that he could independently and safely manage narcotics. Worrisome too, was the extensive media coverage of his overdose and nosy questions asked about his use of Percocet. Prince’s secret was out.

Friends intervened. But it wouldn’t be easy to convince Prince to let anyone manage his pain. The reality is that up until the overdose on April 15th, he had successfully treated his pain for decades. Why give up that control and autonomy? The other reality that Prince confronted is pain management programs treat patients like criminals and take away control and autonomy. Many force patients to sign a “Long-Term Controlled Substance Therapy Agreement.” In Massachusetts and New Hampshire, the law requires opioid contracts. These contracts can cause great harm. The agreement I obtained at the Pain Management Practice clinic at Mount Sinai Beth Israel in New York City has twenty-three regulations that have to be agreed to. Some examples: Unannounced urine or serum toxicology screens, a pill count within 24 hour notice, original containers of medication brought to each visit with all remaining medications, and the waiving of the right to confidentiality. Then the threats: Failure to appear for appointments will be grounds for termination of the doctor/patient relationship, it is understood that failure to adhere to these policies may result in cessation of therapy, and failure to follow the agreement may result in termination of the doctor/patient relationship. These contracts are effectively pain management “parole” in perpetuity. Prince would never sign one. He would not be a slave.

This is what it sounds like
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