The April 21st death of Prince Rogers Nelson, the revered music icon more popularly known as Prince, sent shockwaves across the world. His contribution to music spanned five decades and inspired generations of musicians. Comfortable playing guitar, keyboard, and drums, Prince was also a prolific songwriter, writing not only for himself but also for others, with smash hits penned for the likes of Stevie Nicks, Sinead O’Conner, Chaka Khan, Alicia Keys, Sheila E, and The Bangles. Prince won seven Grammy awards and an Academy Award for the soundtrack to the movie Purple Rain, a semi-autobiographical tale in which he starred. With a genre-bending style that touched on rock, hip hop, funk, pop, soul, and R&B, it is safe to say that Prince was one of the most innovative musicians of the 20th and 21st century.
Prince and his battle with chronic pain
As the world reeled from the shock of Prince’s sudden passing, reports began to filter across the news media. Rumors flew about the cause of death, including most prominently the idea that Prince died of a drug overdose. While this headline in and of itself is sensational, the quiet tragedy behind it is not: chronic pain is a criminally misunderstood condition that millions of people suffer from every day. Prince’s death may serve to shed light on chronic pain, perhaps creating a new dialogue and better understanding and treatments.
Long-time friends and associates of Prince’s report that he was always in pain. Sheila E., a close friend and fellow performer, watched him deal with the consequences of his on-stage performances, saying:
“He was in pain all the time, but he was a performer…I mean, you think about all the years he was jumping off those risers. They were not low — they were very, very high — and to jump off that … First of all, the Purple Rain tour and the way that they were stacked, he had those heels on. We did a year of touring [and] for him to jump off of that — just an entire year would have messed up his knees.”
Hip replacement surgery in 2010 left Prince with a prescription for pain medication but no less of a desire to perform and give every show his all. This drive to keep going, and Prince’s tireless work ethic, made treating his chronic pain holistically nearly impossible.
In the wake of Prince’s death, one thing has become clear: the perception of an addict as a drug-addled street person is a myth. Addiction in the U.S. has a new face, and it’s time to deal with the problem.
Prince’s use of prescription pain medication to manage his chronic pain is not uncommon for those suffering from chronic pain, but it may not be the best way to go. In the days before his death, Prince reached out to Dr. Harvey Kornfeld, an addiction and pain specialist who will be speaking at the annual meeting of the American Pain Society. Dr. Kornfeld was not able to meet with the singer but sent his son, who was among the people who found Prince unresponsive.
Dr. Kornfeld’s group, Recovery Without Walls (RWW), is working to dispel the myths of opiates as a catch-all treatment for chronic pain. A post on the Recovery Without Walls Facebook page highlights the high number of people who depend on opiates while also acknowledging that a number of people are underdiagnosed and undertreated for chronic pain. Dr. Kornfeld is an advocate of using buprenorphine to help opiate dependent people to safely detox. Recovery Without Walls also believes that it’s about more than just getting the drugs out of a person’s system, noting:
“Dr. Kornfeld is a nationally recognized expert in the use of buprenorphine (the active ingredient in Suboxone or Subutex), a medication used for opiate detoxification, maintenance therapy, and pain management. When acute detoxification treatment is required, we arrange 24-hour nursing care, supervised by Dr. Kornfeld. Treating addiction and pain with medication is only one component of an integrated program, which can also consist of psychotherapy and lifestyle changes.”
The public face of pain
The idea that a person who experiences chronic pain needs proper diagnosis, correct and holistic treatment, and understanding and support for daily life is the basis for successfully managing any chronic condition. When it comes to chronic pain, another factor comes into play, a factor which may have contributed to the amount of pain Prince experienced: social stigma.
Upon hearing the news that opiates were found on his body, Prince was immediately lumped into the category of “addict.” In truth, many people who experience chronic pain have, at one point or another, utilized opiates for relief. The brain, the organ that feels pain, very quickly adapts to opiates, relieving the pain. In this case, the brain is dependent on opiates in the same manner as the Type 1 diabetic is dependent on insulin. Somehow, because chronic pain is less easily measured (as compared to a blood test for diabetes), pain patients often have to prove they aren’t faking it or “doctor shopping.” They may be interrogated in emergency rooms or denied by their insurance companies.
The end result of the social stigma is that seeking help for pain becomes a challenge, especially for minority men. When Prince was finally able to reach out, it was too late. As one writer pointed out, it wasn’t pain pills that killed Prince. It was chronic pain.
Instead of demonizing Prince as an addict, now is the time to de-stigmatize the conversation about chronic pain. If you or a loved one suffers from chronic pain, take the time to put a face to the pain. Share your story, and come out of the dark. The more we share about pain, the more people will understand.
It’s time to change the way we look at people in pain.