Positive messages abound as Minnesota Governor Mark Dayton and Lt. Governor Tina Smith declared today, June 7, Prince Day, in honor of the late musician who died in April. He would have been 58.
Public health leaders, addiction specialists and law enforcement authorities however, are getting mired in the messaging around the nation’s opioid epidemic.
That was made even clearer last week when the autopsy results from musician Prince’s death were released.
An attorney for a California doctor and his son who were called to help Prince before he died says his clients did not give the superstar musician any drugs. William Mauzy is an attorney for addiction specialist Dr. Howard Kornfeld and his son, Andrew. He said Thursday his clients "did not deliver, dispense or administer any medication to Prince on the morning of his death or at any other time." He says they had nothing to do with Prince's death.
Drawing the battle lines
Legal experts say the finding that the 57-year-old died of an accidental overdose of fentanyl could make the prospect of criminal charges more likely.
In 2014, nearly 29,000 Americans died from overdoses involving opioids. That figure is three times the rate of deaths from abuse of such drugs than in 2000. According to CNN.com:
Fentanyl, prescribed by doctors for cancer treatment, can be made illicitly and is blamed for a spike in overdose deaths in the U.S. It's 25 to 50 times more potent than heroin and 50 to 100 times more potent than morphine, according to the U.S. Drug Enforcement Administration.
A separate CNN news report said:
Now, federal agencies are trying to tackle the problem in different ways. The Centers for Disease Control and Prevention recently issued guidelines for prescribing opioids for chronic pain, part of an effort to push doctors to prescribe pain medications responsibly. The U.S. Food and Drug Administration announced that immediate-release opioid painkillers such as oxycodone and fentanyl will now have to carry a "black box" warning about the risk of abuse, addiction, overdose and death.
Public health agencies are working to get a handle on the epidemic, but where does that leave people who need relief from chronic pain?
Michael Clark, a psychiatrist and director of the pain treatment program at Johns Hopkins Hospital, said: “Approximately one-third to three-quarters of people with chronic pain experience moderate to severe depression .” In Prince’s case, numerous sources said he lived a clean life but fell victim to debilitating pain from years of performing.
‘A watershed moment’
Dr. Nitin Sekhri, medical director of pain management at Westchester Medical Center, said it’s important that health care providers and family monitor people who are prescribed opioids. ““We’re in a watershed moment in chronic pain management in the U.S.,” Sekhri said. “The jury is out right now on how to move forward, but undoubtedly opioids are a part of chronic pain management.”
Access to treatment was an issue for Prince as well, according to Vox.com:
Prince had been reportedly trying to check in to drug abuse treatment but couldn't get an appointment before he died… [E]ven a rich celebrity couldn't access care in time demonstrates how difficult it can be to get into treatment.
The post continues:
Seeing the rise in opioid abuse and deaths, doctors, clinics, and governments began to crack down on prescriptions for painkillers. Law enforcement, for instance, threatened doctors with incarceration and the loss of their medical licenses if they prescribed the drugs unscrupulously.
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Though tighter regulations are now in place for physicians who prescribe controlled substances, the heavy hand of law enforcement remains. Daniel Denvir writes on Salon.com that the feds should stop looking for someone to blame:
Police departments are now treating overdoses like crime scenes, searching for a dealer’s identity to work themselves back up the drug supply chain. Newfound sympathy for drug addicts, who this time around tend to be white, does not extend to dealers. With addiction, it is easier to blame someone else. And nowhere are calls for retribution louder than when a beloved celebrity dies.
A post on Vivala.com appears to sum up the opioid situation:
Dr. James Gill, chief medical examiner for the state of Connecticut, told NPR that we’re in the midst of an opioid epidemic, and it’s up to medical examiners to gather solid data from autopsies in order to craft a public health response to the crisis. “A death certificate needs to say more than something vague like ‘opioid intoxication’ to help both law enforcement and public health officials curb the distribution — and hopefully abuse — of opioids,” he explained.
Public health agencies are working to educate the patients, families and clinicians about addictive behaviors and chronic pain management. What role—if any—do you think law enforcement should play in this public health conundrum?
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