The shocking and untimely death of musical icon Prince earlier this year saddened millions of fans and fellow musicians around the world—but the news media, particularly in the U.S., seemingly cannot get enough of the salacious, tragic details surrounding the influential musician’s death. Unsurprisingly, many articles from the mainstream media, the music press, and celebrity news sites have focused on Prince’s medication regimen for his chronic hip pain; he was reportedly taking Percocet to manage the pain that plagued him for many years, said to be a result of decades of physical activity stemming from a strenuous performing style.
A full autopsy report has yet to be released—yet the media has taken the “Prince was taking pain pills” detail and run with it, resulting in a veritable avalanche of coverage that lines right up with the most damaging and least nuanced coverage of the “pain pill epidemic” that has been dominating headlines in recent months: He had an addiction problem and was planning to meet with a specialist in the field shortly before he died. There is an arrest warrant out for the doctor who prescribed pain pills to him before his death. He was carrying opioid medication at the time of his death. Few of the thousands of articles written in the wake of Prince’s death engage with his chronic pain issues; many of them merely mention his chronic hip pain, and then fail to bring it up again.
In the rush to paint Prince as an addict—even when it is not clear what other medications he was taking (if any), or how much pain medication he was taking just before he died—any nuance in talking about the unique set of issues that he may have been dealing with has been swept aside, as Lorraine Berry of RawStory contends in a powerful editorial. Instead, many media outlets seem content to imply—or repeat—the “opioid addict” angle without questioning the narrative of opioid medication as always bad even when it is used for legitimate reasons, such as chronic pain.
Along with Berry’s piece, there have been a precious few articles that push back against this tide—most notably from University of Buffalo professor of Pharmacology Jerrold C. Winter, who admirably covers the basic physiology of how opiate medication works, and outlines why use of those medications is one of many tools used to treat chronic pain. In his recent piece for Slate, Winter explains the crucial distinction between drug dependence and drug addiction—and why distinguishing between the two is so important in any conversation about Prince’s death, or any conversation about the management of chronic pain. The news media—and especially publications that trade in gruesome addiction narratives about pain pill misuse and abuse—would do well to heed Winter’s level-headed advice.
Of course, dealing with chronic pain and being a drug addict are not mutually exclusive—it is possible that Prince could have had problems with both. However, the lack of media understanding—and the usual public misunderstanding—of drug dependence versus drug addiction does not help, especially when the media coverage is so one-sided. And as journalist Maia Szalavitz points out in a recent blog post for Scientific American, the number of chronic pain patients who get addicted to opiate pain medication when they are prescribed those drugs is relatively slim:
In general, new addictions are uncommon among people who take opioids for pain in general. A Cochrane review of opioid prescribing for chronic pain found that less than one percent of those who were well-screened for drug problems developed new addictions during pain care; a less rigorous, but more recent review put the rate of addiction among people taking opioids for chronic pain at 8-12 percent.
Moreover, a study of nearly 136,000 opioid overdose victims treated in the emergency room in 2010, which was published in JAMA Internal Medicine in 2014 found that just 13 percent had a chronic pain condition.
The torrent of coverage regarding the role that opioid medication may have played in Prince’s death comes at a particularly strange time for chronic pain patients, especially those who rely on opiates to provide some shred of normalcy in their everyday lives. Recent media coverage of the “pain pill epidemic” has focused on narratives of people who are addicted opioid medications, or who have made the transition to street drugs, but who do not live with chronic pain. As journalist Lindsay Beyerstein has recently written, some experts who are dealing with the “epidemic” on a policy level—and who have considerable access to media platforms such as the New York Times’ op/ed page—have chosen to condemn pain patients who need these medications, instead of attempting to empathize with them, or work with chronic pain advocacy groups to find a solution to the problem that does not further alienate people in debilitating pain.
The voices of chronic pain patients who have had success with correctly prescribed opiate medications seem oddly absent from the mass media narrative; this lack of input from chronic pain patients on the benefits of certain medications has most recently reared its metaphorical head in the Center For Disease Control’s recent recommendations regarding prescribing of opiate medication for chronic pain. Members of the online chronic pain community have taken to social media to push back against the CDC’s recommendations—however, it remains to be seen whether the CDC, FDA, or other federal regulatory bodies will listen.
Prince lived in circumstances that are, and were, extremely different from that of most chronic pain patients. Regardless of his level of drug use to manage his pain, his unfortunately early death should not be used as a “gotcha” to further deny useful medication to people who legitimately need it.
Photo: Juan Bendana/Creative Commons