The Rich and Famous Part II
I kept you on your toes for a few days, but here is Part II of my blog series “—the Rich and Famous.” In this post, I discuss Prince’s overdose and the unfortunate dangers of stigma and privacy surrounding (particularly among the rich and famous) and how it affects everyday people struggling.
A quagmire the rich and famous often fall into when struggling with substance use disorders is that of stigma and privacy. Our culture has adopted the 12-step rehab point of view that are a “character flaw” or moral failing and that people who use drugs are “dirty,” “addicts,” “meth heads,” “junkies,” or “druggies.” As a result of such stigmatizing views, people are apt to be secretive about their struggles. This need to be secretive is amplified exponentially when people are wealthy or famous. They have a “brand” to protect. The fear of stigma and profound need for privacy amongst these folks often lead to attempts to circumvent the process of traditional help-seeking thereby creating new, clandestine paths cloaked in secrecy to protect themselves. Unfortunately, these efforts have unforeseen, and often deadly, outcomes, as was the case of the famed musician, Prince.
Prince’s Overdose—The Danger of Stigma and Privacy
Let’s take an example from my backyard. In 2016, the über talented, iconic music figure Prince died of a Fentanyl overdose in his home/recording studio at Paisley Park in Minnesota. Just a few days before, according to multiple sources, Prince’s private jet suddenly detoured in route from his concert in Atlanta to land in Moline, IL so he could be treated with Narcan (Naloxone) for an opioid drug overdose. As reported in the press, Prince’s intense need for privacy led him to conspire with a local family physician who treated him and provided him with opioid pain medications under an alias. , Prince sought treatment away from his home base in Minnesota (likely due to privacy concerns and the rehab patterns of the rich and famous).
Prince and his representatives arranged for Dr. Howard Kornfeld to treat him, who, according to the St. Paul Pioneer Press “operates an outpatient medical center in bucolic Marin County (California), [and] received publicity in the San Francisco Bay area in 2013 for his work with Buprenorphine [a medication used in the treatment of Opioid Use Disorder].”
Dr. Kornfeld sent his son, Andrew, a medical student, to see Prince in Minnesota as he apparently was not available on such short notice. Andrew came equipped with Buprenorphine to treat Prince (the ethics of which are highly questionable in terms of how this was done and by whom). Unfortunately, Andrew arrived at about the same time that Prince’s bodyguard arrived to find Prince dead (of a Fentanyl overdose) in the elevator at Paisley Park.
Were it not for his fame, the stigma his intense need for privacy, Prince might still be alive today. Had any patient, nonetheless Prince, called my office (a mere 30 miles from Paisley Park) in need of treatment with Suboxone for Opioid Use Disorder on that day, or any day, they could have been seen and prescribed that life-saving treatment the very same day. What a shame that Prince felt the need to so secretively and privately seek out a well-known figure in California, when my colleague, Dr. Mark Willenbring (founder of Alltyr, one of the practices I work in) is a world renowned psychiatrist practicing right here, in Prince’s backyard!
The Rich and Famous—Deadly Examples
Many questions remain as to what might have happened or could have happened in the cases of Demi Lovato, Prince, and countless other rich and famous people who seek treatment based on what the rich and famous have done or what they should do, rather than seeking out the best evidence-based treatment available. This matters because thousands of everyday people struggling in this country die every year. In fact, you may want to check out this recent New York Times article, “Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017,” citing that the number of deaths from overdoses is “higher than the peak yearly death totals from HIV, car crashes or gun deaths.” Unfortunately, what gets popularized as to what people should do when seeking treatment is what they see the rich and famous people doing in the news and on social media. Demi Lovato pointed to this herself in an article from E! News,
“Following her overdose, a source told E! News that Lovato had made the decision to go to rehab because ‘she wants to make a statement to her fans, family and friends that she is strong and can recover.’”
Well known people, the press and social media set a deadly example for the average person when they popularize poor choices regarding seeking out non-evidenced based treatments for this behavior leads to much unnecessary suffering and death. We must stop just calling chronic illnesses and start actually treating them like chronic illnesses. (As a sidebar, the press is now reporting that Demi Lovato’s overdose was from Fentanyl laced Oxycodone, ironically (or not) the same drug that Prince overdosed and died from).
The rehab industry’s stranglehold on must end. But what incentive does the treatment industry have to change now when they have a multibillion dollar juggernut and no one to answer to? The current structure for treating , including the government’s approach with Medicare and Medicaid and other health insurers, needs to change. Evidence-based approaches that are cost-effective, patient-centered, and provide ongoing care must become the norm. When the government and private payers start to insist on better outcomes, as they would for any other chronic disease, and stop paying for rehab facilities that provide ineffective treatment paradigms, things will change. As for the rich and famous (see Part I), we need to find ways to make treatment accessible to all and combat the stigma which leads to poor choices around seeking, or not seeking, appropriate care for those suffering psychiatric disorders.
