So now we know what killed Prince. He died trying to control the pain in his hips that had become chronically damaged through years of jumping, hyperextending them on stage and running around wearing high heels. Rather than using conventional painkillers such as paracetamol and non-steroidal anti-inflammatory drugs, the usual bedrock of treatment in such cases, he self-administered the powerful opioid drug fentanyl that then rapidly shut down his breathing, leaving him dying alone in a lift in his Paisley Park studio.
The irony is that, while Prince was notorious for being teetotal and anti-drugs (his rules applied to anyone entering his building), he gave himself a drug that is 80 to 100 times more potent than morphine and 40 to 50 times more potent than pharmaceutical grade, or 100 per cent pure, heroin. Used as an anaesthetic in the 1960s, it was introduced for more widespread clinical use in the mid-1990s, and is now thought to be the most commonly used synthetic opioid in clinical practice. Unfortunately, along with its dramatic potency comes significant risk. Just as with all other opioid drugs, fentanyl can suppress the breathing centres in the brain, especially in someone who is either not used to taking it, or who catastrophically misjudges the dose being taken. Standard practice is that it is not prescribed for someone who has not taken opioid drugs before and even then only extremely carefully.
If reports are to be believed, Prince was flirting very dangerously with opiate drugs and their effects. Several American media outlets reported shortly before his death that he had been struggling with painkiller addiction — and fentanyl is at the top of this particular league — as well as having been treated with the drug Narcan, usually used to reverse the effects of overdoses of opioids. He had also reportedly been using a walking stick to help him with his hip problem, although he was never seen in public using it.
Unlike the long list of rock stars who succumbed to the effects of opioid drugs used for recreational purposes, Prince appears to have either gradually developed an increasing tolerance and need for fentanyl over some time, or accidentally got his dosage wrong with catastrophic consequences. Unfortunately he’s not alone. Unintentional fentanyl overdoses appear to be steadily increasing and in America alone in late 2013 and 2014 over 700 fentanyl-related overdoses were reported to the Drug Enforcement Agency.
As far as street drugs are concerned, fentanyl is usually cheaper than heroin and so drug dealers often lace heroin with it to boost their profits, creating a potentially lethal mix in the process to unwary users. Opioid addicts often prefer fentanyl alone, as it gives a very rapid high and is so powerful, but are playing with their lives whenever they take it.
When used correctly in a clinical setting it can be a source of huge comfort to patients (such as those suffering cancer pain, for example), but Prince has highlighted the other side of opioids in the most extreme way possible. This king of trend-making music fell victim to a different trend, this time from a medicine packet.