Tuesday (which was Wednesday here) would have been Prince’s 58th birthday. The date seems to have passed with little global comment.
In fact it took so long for the autopsy results (or rather, their abstract) to be released, that the media in general seemed to have lost interest. “What, is he still dead? Oh well, here’s Trump saying something stupid.” It’s likely that all of the speculation around long-term prescription drug use made the actual autopsy results seem like nothing more than a confirmation of what we already knew… but the fact is that we actually know very little, and the official document is frustratingly lacking in detail.
We now know what Prince weighed at his time of death (112 lbs), but we don’t know if the fentanyl that killed him was prescribed or street-bought. We don’t know whether he exceeded his prescribed dose or simply reacted badly to it. We don’t know if he had drunk alcohol or taken benzodiazepine, both of which make opioids more likely to suppress your breathing. We just know that he took fentanyl and it was probably self-administered (fentanyl is generally given as a patch, so it’s probably safe to assume that no one forced him to wear it).
At the end of the day, this should probably matter to no one other than his family and close friends. He was a private guy, so it does seem gratuitous to haul out too many details about how he spent his last hours. However, it matters simply because opioids are everywhere. Millions of people take them (myself included). Sometimes they are over-prescribed and sometimes they are likely under-prescribed, so a high profile death from opioids affects the ongoing decisions made by many, many people. If we don’t have the whole picture, and if we simply declare “he took too much”, we have a tendency to require that other people take less… without knowing how much less, or why, or for how long.
If instead the story is “he lived with chronic pain, took fentanyl for years without it killing him, but decided that day to have a couple of cocktails” it creates a very different understanding of how other people should be managing their opioid use. If the story is “he took it for years, then tried to quit cold-turkey, then went back to it”, again it creates a different, better understanding of managing rehab for opioid users.
I can think of another celebrity death that fit exactly this model: Amy Winehouse. Her problems with drug and alcohol abuse were well known, and when she died alcohol seemed to be the obvious culprit. Except that it turned out that she’d been trying to quit and had abstained from drinking for a while. When she started again, her tolerance was lower and it killed her. That seems to have changed many people’s awareness of the fact that stopping a chemical addiction should be a monitored process, with medical assistance if necessary. Quitting isn’t just about willpower – sometimes it might really kill you.
The fact that Prince was treated for an overdose just a few days before his death would tend to suggest that his path may have been a similar one. Did he cut off his dosage, find himself in terrible pain after a few days, and then restart again? It matters only because telling the world that opioids killed him will no doubt lead a lot of people into trying to quit.
In the past week, I’ve read all about how opioids are the devil, how opioids are fine so long as you know how to use them and how to quit, how we really don’t understand Prince’s medical requirements, and how we may never get the facts necessary to be able to make a sensible, adult assessment of what happened and what we can learn from this talented man’s early end. Altogether, the massive lack of consensus just makes me very sad.
It’s a reminder that Prince’s death, while tragic, doesn’t have to be wasteful. If only we can learn.