Iconic rock star Prince died on April 21 at the age of 57. According to numerous media reports, the likely cause of death was opioid overdose. According to reports, on the way back from a concert a week before his death, Prince’s plane made an emergency landing and Prince was administered Narcan by EMTS to revive him from a Percocet overdose.
Apparently, Prince lived with chronic hip and ankle pain as a result of repeatedly jumping from heights during his act. In 2010 he had hip replacement surgery. He was prescribed Percocet to deal with continuing pain. Although Prince “partied” in his youth, he was known in recent years for his “clean living” and was not known to abuse drugs.
So, how could Prince, an extremely wealthy individual with access to the best medical care, die of an iatrogenic illness (an illness caused by his medical care)? Most likely, like the vast majority of people in pain, he trusted that doctors were most qualified to treat his pain. The reality is that most prescription painkillers are prescribed by primary care physicians whose medical school training included less than two hours of training on pain. Primary care physicians get most of their “education” about pain from pharmaceutical company representatives. Most physician pain specialists are anesthesiologists, who are trained to numb pain, not investigate and remediate its causes. As one astute physician told me, most anesthesiologists are not even trained to work on conscious patients!
Opioids, in fact, are not a good way to treat chronic pain. At first, they do reduce pain. However, over time most patients develop tolerance, where higher doses are needed to achieve the same effect. This is because the body produces its own natural painkillers and adapts to the presence of opioids by reducing their production. Increasing doses of opioids result in more side effects and greater risk of addiction and overdose. Also, when there is reliance on opioids to treat pain, the underlying causes of the pain do not get addressed.
If Prince had used these safer, more effective treatments for his chronic pain he would still be with us:
- Marijuana – a very effective pain reliever that does not cause overdose. Marijuana can also help prevent development of tolerance in opioid users and help them wean off opioids. (In Minnesota, where Prince lived, it will be legal to treat patients with intractable pain with medical marijuana as of August 1, 2016.)
- Low level laser therapy – uses infrared light to reduce inflammation and promote tissue healing, which reduces pain. Proven effective for muscle and joint pain.
- Massage – helps with muscle soreness, which is the main cause of pain in most pain conditions
- A therapeutic exercise program – strengthens muscles, reduces stiffness, improves range of motion and lubricates joints, all of which reduces pain
- Optimized nutrition with vitamin, mineral and herbal supplements
With his immense wealth, Prince had choices about his care. Most pain patients, especially those whose ability to work has been compromised by chronic pain (the paupers in the title of this article) do not have access to the wide range of alternative pain treatments available due to financial constraints. These patients may know about and be open to alternative pain treatments, but their health insurance refuses to pay. They are forced to rely on pharmaceuticals like opioids that do not address the cause of their pain and pose grave risks to their health.
Please sign my petition on change.org asking President Obama and Congress to pass a law requiring health insurance to pay for all proven treatments for chronic pain and to require physicians to be educated about them. You can sign the petition here: www.change.org