RIP Prince

[MoonSister75]

I found this article, written by Andrew Kornfield who found Prince

http://edition.cnn.com/2016/06/03/op...ince-kornfeld/

Editor's Note: Andrew Kornfeld graduated from the University of California, Santa Cruz, in 2013. He studied neuroscience and psychology, and now works with his father at Recovery Without Walls, their addiction outpatient clinic in Mill Valley, California. He is a writer and is currently applying to medical school. The opinions expressed in this commentary are solely those of the author.


(CNN) — As the media has duly noted, I am the "pre-med student" who flew out to Minneapolis to help Prince find the road to recovery but who ended up calling 911 instead. Sadly, we now understand from the medical examiner's report that he died from a self-administered dose of the powerful synthetic opioid painkiller, Fentanyl.

I know many of you are eager for details; understandably, you want to know what transpired that day. Believe me, nothing can prepare a person to walk into such chaos and sadness. As I told the 911 dispatcher on April 21, those on the scene were distraught, which was why I was the one to place the call. But what happened has made me think, long and hard, about what steps we must take to prevent such entirely unnecessary loss of life.

From the beginning, my dad, Howard Kornfeld, MD, instilled in me a love for the way life works, in all its beauty and complexity. We spent our days together exploring Northern California's mountains and oceans -- the wonders of the place we call home. The evenings found us in a big comfortable chair, where we pored over images of cells and animals in the pages of a well-thumbed biology textbook. He taught me that health is the foundation to all else, in regard to human life.

While I was finishing elementary school, my dad emerged as a pioneer in the fields of pain and addiction medicine, joining a cadre of physicians who utilized new, evidence-based practices for their opioid-dependent patients. A medication called buprenorphine was at the forefront of their work. Its efficacy in treating addiction has since been well-documented. Patients with opioid addictions have a significantly higher chance of survival when buprenorphine is part of their treatment.

Many people become addicted to opioid painkillers because they are prescribed them as treatment for chronic pain conditions. The media reported that Prince was one such patient. But, as media reports over the last several years have made clear, what begins as a "harmless" short-term prescription of opioids can turn into a long-term dependence.

I have Crohn's Disease, an autoimmune disorder that afflicts the gastrointestinal tract, so I am no stranger to chronic pain. While I am extremely healthy now, during my sickest moments, and in the aftermath of multiple surgeries, there is nothing I wouldn't have done to escape the agony. The millions of individuals who suffer from chronic pain are familiar with this sense of desperation. They run the gamut: your next door neighbors, the celebrities you read about in magazines at the supermarket checkout, and yes -- Prince.

His death was a tragedy beyond words. He was an inspiration to so many, and in the brief time I spent in Minnesota, I saw just how good a friend he was to those closest to him. In the weeks that have passed since April 21, I have thought about what might have produced a different outcome. What if his troubles could have been addressed effectively, and much sooner?

Unfortunately, the timely care Prince may have needed, based on the medical examiner's report, has been difficult to obtain in Minnesota, and in many states in our nation. According to the Minneapolis Star Tribune, there are 120 buprenorphine prescribers in the state, roughly 2.2 physicians certified to prescribe the drug, per 100,000 persons -- not nearly enough.

Right now, we need medical interventions for opioid dependence and addiction more than ever, because in the U.S. we're losing 28,000 people every year -- a number that would average out to 77 people daily -- to opioid overdoses. In addition, evidence suggests that we must call into question the success of abstinence-only methods.

When a user relapses after "going cold turkey" (the protocol in an abstinence-based program), and then takes a higher dose than he or she previously tolerated, that dose may prove fatal. Treatment with buprenorphine instead not only diminishes the chances of overdose, but also reduces the likelihood that the patient will relapse.

I have learned from my father that when a patient is in withdrawal (especially from opioids or benzodiazepines, which reduce anxiety or sleep problems), he or she will experience intense physical symptoms, coupled with feelings of vulnerability and powerlessness. Because buprenorphine helps to eliminate the craving for opioids, and reduces the brutal symptoms, it can give the patient the opportunity to develop healthy life habits and healing behaviors, which can readily become entrenched.

Over the last two decades, the overwhelming scientific consensus holds that such beneficial brain changes can occur at any time in life. Harnessing the full potential of what scientists call neuroplasticity doesn't happen overnight, and more research is required, but it is possible that part of buprenorphine's success lies in its ability allow such neurological changes to take place.

As I make my plans to apply to medical school, my father's work is foremost in my mind. As the Centers for Disease Control and Prevention has made amply evident in announcements over the past two months, we are going to be dealing with the fallout of the opioid crisis for decades. There will be legislative challenges, as well as stigma and misinformation to battle, as we inch toward a meaningful solution.

It is easy to find yourself caught in a web of pain, and difficult to escape. I know this. So do many of my father's patients, treated with buprenorphine, who have mustered the energy and the courage to come join me as we paddle surfboards in the chilly waters off of Northern California's coastline, the sunlight near the horizon interrupted occasionally as near-perfect waves roll in.

What if my father and had been able to reach Prince just a week earlier, like so many others we have helped take back their lives? Prince could have been here, standing on the beach beside me.

[Missy]

Yet to read everything here but Fentanyl sounds like a terrifying drug http://clatl.com/atlanta/metro-atlan...t?oid=14326432

I'm in hospital and was chatting about it with a nurse. She was quite startled but that's in the medical report.

It can be a very useful pain reliever, but when abused or not administered correctly it can be very dangerous.

I'm in Australia and I think they are stricter about prescription drugs here. Difficult to get anything like Valium or Xanax.

In some ways, Prince had a troubled life. His unstable childhood, being bullied, loss of his only born child. As I said earlier though, he was such a private person, he may have found it very difficult to reach out for support or a rehab. He would've hated people finding out.

At least AIDS and HIV appears to be discounted by these results. Will be interesting to see who might face charges over this. Yes, Prince himself made a bad choice. But doctors are supposed to be dependable and no way should they prescribe in excess to someone who is addicted to a drug. What can we do here?

[welcomechris]

Originally Posted by Missy

Well it looks like they ruled out AIDS or HIV status.

Fentanyl is a terrifying drug, and many people are abusing it.

I wonder how Stevie feels about this - knowing the way that he frowned on her drug use. Who would have thought he would go first, and she is still going fine these days.

So many ironies. In some ways he had a difficult life. He spoke about being bullied as a kid, family problems, and his only child died not long after being born.

(That's if there isn't any secret kids out there, as some are claiming. Well they can go get a DNA test.)

Very sad loss. I loved Prince and his music. I don't know if this rules out the HIV rumor however, he could have just figured "Screw it, I'm already sick, Why not just go have fun"

Regardless, what a terrible loss. He will be missed.

[Missy]

Originally Posted by welcomechris

Very sad loss. I loved Prince and his music. I don't know if this rules out the HIV rumor however, he could have just figured "Screw it, I'm already sick, Why not just go have fun"

Regardless, what a terrible loss. He will be missed.

From what I have seen, his cause of death report seems to rule out any other factors.

http://www.mirror.co.uk/3am/celebrit...v-aids-8106479 Yes it's a tabloid and perhaps not best standard but:

Rumours Prince died from either HIV or AIDS appeared to have been refuted following the official report of his death, which stated that the star was killed by an accidental opioid overdose.

The Midwest Medical Examiner's Office confirmed yesterday that toxicology reports confirmed the Purple Rain singer died of an accidental overdose of Fentanyl - the same drug that caused Michael Jackson's death in 2009.

They also stated that there were no "other significant conditions" that led to his death, which appears to refute the allegations his died after a secret battle with HIV or AIDs.

I was skeptical that he could do a tour of Australia going halfway around the world, if he was seriously ill. Reviews noted that he seemed shaken by the death of his former partner, but nothing else was noted that seemed amiss.

Of course, there ARE other people claiming paternity and will probably have DNA tests. But he had no acknowledged surviving children.

I am wondering if he decided, just before going into rehab, to have one big final dose. When you have been taking a drug long term and have high tolerance, it's very easy to take too much. You think you can handle any amount.

But then if you kick it for awhile and then take it up again, your tolerance is lowered and if you take your former dose, the risks are very high.

I wonder how Stevie is feeling about this. Prince used to frown on her drug use, and now she is the survivor while he has become a casualty. Stevie of course has done her battle with both prescription and illicit drugs. But as she has said, you can talk to them until you are blue in the face and much of the time, they will not listen. You may think you will never let yourself become a victim of addiction, but the tables can turn. It's a very powerful evil that can take some of the best.

r.i.p. Prince and thank you for the musical memories. My father passed away in April and on the day of his funeral, I heard about Prince. I was listening to 'Purple Rain', 'Nothing Compares' etc on that day.

[Missy]

Someone who was with Prince on the flight a few days before his death, has described in scary detail his medical emergency.

http://www.nytimes.com/2016/06/22/ar...ill-plane.html