While Tests Are Still Pending, It Is Possible to Draw Some Conclusions About Prince's Drug Issues

This article was originally published by The Influence, a news site that covers the full spectrum of human relationships with drugs. Follow The Influence on Facebook or Twitter.

When a famous person dies mysteriously and prematurely these days, we are instantly led to consider their drug use as cause of death.

Prince, the multitalented musician and entertainer, who was found dead at his estate outside Minneapolis last week, is a prime candidate for such speculation. We need to withhold judgment until toxicology and other autopsy data are made public, of course. But current reports suggesting that drugs played a major role in his death, and how they did so, speak to a much wider point: Americans’ lack of skill at drug use.

It is unusual for a 57-year-old to die instantly, from no visible cause. Sometimes heart attacks act this way. But Prince didn’t appear to suffer a heart attack, he wasn’t known to suffer from heart disease, and he didn’t display such risk factors as smoking, obesity and lack of physical activity.

But the outward signs of his death are consistent with drug poisoning, or the combined effects of various narcotic and depressant drugs. (The New York City Medical Examiner’s Office finds multiple drug use present in 97% of drug-related deaths.)

Prince was famous for his “clean” lifestyle. In addition to not smoking or drinking, he was known as being vehemently anti-drug, eschewing marijuana, cocaine and other street drugs. But his hands-off approach seemingly didn’t hold for pharmaceuticals, particularly opioids.

We are now being fed information that the emergency landing of Prince’s plane several days prior to his death was due to a narcotic overdose requiring an injection of a narcotic antagonist such as naloxone. TMZ has also published photos of Prince in a parking lot supposedly waiting impatiently for someone to bring him a prescription for the painkiller Percocet.

But people don’t tend to die unintentionally from Percocet prescriptions. A new, more plausible narrative is emerging: sub rosa use by Prince of prescription opioids whose effects were compounded by other, medically prescribed painkillers.

According to the Daily Mail, “the performer’s longtime dealer—who asked to be named only as Doctor D—revealed the singer would spend up to $40,000 at a time on six-month supplies of Dilaudid pills and Fentanyl patches.”

People usually have an explanation for such drug use. According to Dr. D, “Prince suffered crippling stage fright and could not get on stage and perform without the drugs—but had a phobia of doctors so could not obtain a prescription legally.”

This still does not add up to deadly drug use. We might be surprised at prominent people’s regular use of pharmaceuticals in support of both their daily lives and their public, performing selves. But few die from such use.

Added into this mix was that Prince was known to be suffering from hip pain. “Dr. D suggests it could have been a physician that unknowingly contributed to Prince’s death—by prescribing strong painkillers to the singer for his hip condition without knowing the extent of his secret opiate addiction.”

While the veracity of Dr. D’s account remains to be seen, it has the advantage of making sense by proposing how a well-heeled individual, able to receive the best of health care, could end up overusing combinations of narcotic drugs that could kill him.

If this account ultimately holds water, it brings to the forefront several regrettable elements in Prince's biography, and leads us to these conclusions about unhealthy and dangerous drug use:

• Being anti-drug—meaning anti-recreational drug use—is no guarantee a person won’t overuse meds in dangerous and addictive ways (think Elvis, Michael Jackson and Rush Limbaugh). Indeed, this ambivalent attitude toward 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.
• Prince seemingly was an isolated person. He lived alone and was only discovered dead by employees entering his estate in the morning. Having intimate human associations and others monitor one’s behavior and ongoing health can be lifesaving (think Amy Winehouse, who died alone from a combination of alcohol and benzodiazepines prescribed following rehab).
• Prince failed to display open acknowledgement of his drug use and awareness of best drug-using practices.

All Americans use drugs, whether legal or illegal. A mature response to this situation is to acknowledge it and seek to make drug use safer, as opposed to denying it, stigmatizing it and thereby encouraging individuals like Prince to remain secretive, uninformed and vulnerable.

Based on these early reports around Prince’s death, one might suspect that he, like many other Americans, tragically lacked needed skills and knowledge around drug use.