First There Was Prince. Now Tom Petty. When Will America Finally Wake Up to the Opioid Crisis?
When pop star Prince died in April 2016, a gaggle of health care researchers and reporters—including me—tried to see the silver lining in his surprising, opioid-linked death. If even Prince, a famous teetotaler with access to the best medical care, could end up addicted to painkillers, surely that would show that the opioid epidemic was reaching every corner of America. Maybe in death, his celebrity could illuminate the high stakes of the crisis and force a reckoning.
We were very wrong. More than 55,000 Americans—rich, poor, famous and not—have since died from their own opioid overdoses. The latest data from the Centers for Disease Control and Prevention (CDC) suggests that the death rate in 2018 could be even worse. And Friday night’s news that rock star Tom Petty died from his own preventable painkiller overdose, more than a year after Prince, underscores how far there is to go.
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In health care, there’s a quest for celebrity patients—a symbol who can galvanize change. It’s a strategy that’s worked before. Ryan White, a teenager in the 1980s, became the face of HIV/AIDS and helped drive research and reforms. More recently, actor Michael J. Fox raised awareness of Parkinson’s disease; Angelina Jolie’s op-ed about her breast cancer risk spurred a spike in genetic testing.
That hasn’t really happened with painkiller deaths, perhaps because there are too many famous faces to pick from. Actors like Heath Ledger and Philip Seymour Hoffman. Musicians like Prince and Petty. And it’s far from a new trend. Even Elvis Presley, who died 41 years ago, was dealing with painkiller addiction.
A celebrity’s death from painkillers also has lost its ability to shock and awe. “No one is surprised when they hear about a rock star dying of a drug overdose,” said Andrew Koldony, an addiction expert at Brandeis University. “In some ways, it reinforces the stigma around addiction or that it only happens because of a certain lifestyle. Of course, that’s not true at all.”
Prince and Petty, for instance, were both dealing with chronic pain—like millions of everyday Americans—and seemingly got hooked on drugs in their attempts to manage it. Petty’s family said he played 53 separate shows while using legally prescribed medication to deal with a broken hip; his death was reportedly an accidental overdose of a mix of those legal drugs.
The details of Prince’s death remain less clear, but investigators note that he had apparently overdosed just six days earlier, after a performance, and was administered an emergency recovery drug—a worrying sign of the depth of his addiction. He also had been hiding a mix of different painkillers in aspirin bottles, with at least some of those medicines apparently prescribed to his bodyguard for privacy. Prince had suffered ankle and hip problems for years, with multiple reports that he’d undergone major hip surgery
Neither celebrity was blind to the risks. Petty had previously beaten a heroin addiction; Prince was scheduled to meet with an expert for painkiller treatment the day after he died.
“Prince was not a drug abuser” in the traditional sense of celebrity rockers, Kolodny stressed. “He was a religious guy. He was a vegetarian. You couldn’t smoke pot or drink alcohol on tour with him.”
But there’s a deeper reason why a celebrity death hasn’t arrested the opioid crisis: The problems are systemic, and too entrenched to be shaken by a few high-profile victims. About 91 people now die from opioid overdoses every day, the CDC says—a conservative estimate—thanks to a potent mix of stigmas, addictions, lack of awareness and inadequate access to care and prevention.
“Too many people still think it’s a moral failing,” said Regina LaBelle, a drug policy official in the Obama administration. “Too many doctors don’t screen for or recognize addiction, so we have too much untreated addiction.”
The opioid epidemic has also made some pharmaceutical companies very rich, a real barrier to getting the industry to buy into change. Sales of prescription opioids almost quadrupled between 1999 and 2014 as the number of prescriptions soared. By 2010, there were more than eight opioid prescriptions for every 10 people. Purdue Pharma, the makers of OxyContin, have sold more than $25 billion worth of the drug in the past decade.
Meanwhile, more than 250,000 people died from opioid overdoses in the past decade. Some projections say that could double in the decade ahead, under worst-case scenarios.