There it was on my Facebook feed this week: Trending: Prince. Why was Prince a trending topic when he'd been found dead a month ago? Then I learned his official cause of death had just been released: "Accidental Fentanyl toxicity." In other words, he unintentionally overdosed on a drug he was taking to treat chronic pain. After reading the comments on the various new Prince articles, it hit me: though Prince's body died of opioid overdose, the autopsy report may as well have said "death by ignorance and fear," both his own, and the public's.
If "death by ignorance and fear" sounds inflammatory and sensational, stop and think about it. Why on earth would anyone wait to get medical help for something that could kill them? Would you furtively seek treatment if you realized you had something potentially fatal? Would you wait until things were so bad that your life was literally falling apart and you were afraid you might die? No. You'd rightly engage in proactive self-care and get professional medical treatment, with no fear that anyone would proclaim you as weak-willed and morally bankrupt. You would do it with no fear that it might permanently damage your reputation, your career, or negatively affect your family. But that's not the case with addiction and mental health.
Because of his fear of what had become his "secret" getting out to the public, Prince passed off an emergency plane landing due to overdose as "the flu." The public's eyes were on him, and treatment that would have saved his life was delayed. Why? It is primarily the ignorance and fear of an addiction-shaming and tabloid culture that drives public figures to make such insane decisions. The press and public surely would have turned the very normal act of Prince seeking medical treatment for his condition into scandalous fodder, something the very private Prince–or anyone–would likely choose to avoid.
Most of the reactions to the cause of death news were disheartening to read, partly because I used to work for Prince, who was as straight an arrow as they come. I was 22 years old and got a gig as the production secretary for his second film, "Graffiti Bridge," shot at Paisley Park Studios in Chanhassen, Minnesota. I wasn't on set much, mostly working in the production office, which was on the main floor, right across from the elevator that led upstairs and to Prince's private quarters. That was usually where I saw him, stepping out of the elevator door in the morning. So when I heard that his body was found in the elevator, it was a jarring visual contrast to the spry cannon of energy that bounced out of that door every day in four inch heels.
I liked working at Paisley Park, it was a very professional environment, but also had a community feel to it, and I felt like I was a part of something. When George Clinton would do his scenes, he would ask me to watch his grandson for him and we got chatty over time. I was even able to get my brother a job on the film, doing security patrol. It seemed to me that Prince took the good will that Warner Bros. showed in building Paisley Park, very seriously, and passed it on to others. It was a not a glorified man-cave or over-priced party house. Prince ran the place like what it was–a world class production facility with a massive soundstage, recording studio, and performance space. From my observations, the partying took place offsite and did not involve Prince. (It was apparently in George Clinton's wheelhouse, however.)
I remember processing Prince's W-9 form for payroll and seeing that his legal first name really was Prince. "Prince Rogers Nelson," it read, and then his social security number. Prince was human–a person working hard for his paycheck just like everybody else. I remember him taking some actors into the hallway to teach them complicated dance moves for an upcoming scene–again, in 4-inch heels. Prince was a petite guy, but he wore those heels well, and could move nimbly in them, and he seemed to be moving all the time. I can't help but fast forward now to the ensuing decades of performance and the toll it obviously took on his body, leading to his double hip replacement surgery in 2010. The surgery failed to relieve his pain, and so his long-term chronic pain treatment began.
That job was my first experience in major studio film production, and I learned a ton. I was grateful for the opportunity and the stories I had from it. The last time I saw Prince was when he threw the film's wrap party at Paisley Park. Everyone was invited and could bring guests, from production assistants on up, and were treated by our host as equals.
At that time, I had only just begun teaching myself how to play bass, so I would never have believed that in years to come we'd both have stars on the wall outside of the Minneapolis rock club he made famous, First Avenue. His, of course, for being Prince, and mine for my years as the bassist in Minneapolis band Babes in Toyland. I've played numerous gigs at that club, and we shot a music video there, but it was an indescribable honor for our band to be on the same wall as him.
Though Prince and I may have both been musicians who shared a city, I am sure as hell not drawing parallels in our careers. I have not gone on to sell 100 million records like he did. And I didn't blow people's minds playing the Superbowl. I can't dance in 4-inch heels. I can't write hit songs as easily as jotting down a shopping list. Nor was it my time working for him that feeds my empathy about his death and the public's reaction to it. What I have in common with Prince are my personal experiences with chronic pain and addiction. I'm a recovering addict 12 years sober, but an addict nonetheless, and I deal with pain daily. Glancing at comments like "He did it to himself," "Surprise, another rock star drug addict," and other victim-blaming attitudes, angers and upsets me.
I know what it's like to live in chronic pain. I've survived four car accidents, none of which I caused, surprisingly. Each one incrementally worsened my neck pain to the point that after the third one in 2011, I agreed to have cervical spine surgery to relieve it. Surgery was risky, and not a quick fix, but I couldn't imagine living in pain like that any longer. It also involved an extremely long recovery–and being on painkillers most of that time. I struggled with them, but it was an unavoidable part of my treatment.
My doctor knew I was an addict, but it was the only option for treating the inevitable and severe pain–and severe it was. Sure, it killed the pain as I recovered, but it also gave me a wonderful feeling–peaceful and anxiety-free–an instant vending machine happiness, which, for someone with Depression, is delightful. That is what I struggled not to cling to. That, I knew, was addiction. I was weaned off of them, and thankfully I lived pain-free for four years. Last year, another accident brought it back. Though it is chronic, the pain is not as severe as before, so I am able to avoid opioids. It is nothing like the pain Prince was enduring. I can't imagine living with severe pain for the rest of my life, like he was facing.
In the case of prescription opioids, these people are not addicts looking for a high, but for relief from their pain. Fentanyl is up to 100 times more potent than morphine and can be 30 to 50 times more powerful than heroin. Even when taken in small amounts, it can be fatal. Neuroscientists know that addiction is a brain disease, but most people don't. There is a huge gap in the public's understanding of it as a medical condition, not a choice or moral failing, but a progressive, fatal disease.
Though my original addiction was to another substance, it almost killed me, as it does so many. Prince wasn't as lucky as me. My incident happened two blocks away from a hospital. I was saved, the ER doctor later told me, by how quickly I got to the hospital. Five minutes later and it would have been curtains, as she put it. It was shortly afterwards that I got sober.
Prince may not have been happy about the need for addiction treatment, but he knew it was time, and he had a close enough call on the plane to ponder the thought that his addiction could end his life. Clearly, he wanted to live. But he didn't want anyone to know. Sadly, addiction is particularly lethal in the case of performing artists with egos and identities whose destruction could mean the end of their careers. Hide it, hide it, hide it. Hide it from you. Hide it from us.
From my perspective, lumping Prince into the bin of rock stars done in by overdose, dismissing the tragedy as another example of excess and bad choices, is not only inaccurate, it perpetuates dangerous attitudes and ignorance about chronic pain and addiction. Every medical treatment has inherent risks. So why the shame?
We didn't disavow David Bowie for treating his cancer with chemotherapy, though the side effects made him sick in many ways. Bowie was a patient seeking relief, and that's what Prince was doing, too. In his case, it was chronic pain. The most common treatment for that calls for a dependency on prescription painkillers. It's not like he became addicted by surprise or chance. It is a known side effect of treating pain with painkillers. The management of that pain is tricky business, as pain is measured by self-report and not observation. Where I believe mistakes were made is in secrecy and shame, which our culture demands in exchange for perceived indulgence in narcotics, prescribed or not.
The tragedy that treatment had been delayed and sought through back channels to avoid detection–that is what the focus should be on. Shaming for the treatment of addiction and mental illness is everywhere, and its impact is very real. In my own first year of sobriety, I met a young woman in AA who, like me, also suffered from clinical Depression and was on prescribed anti-depressants. Unfortunately, her sponsor was one of those people who believe that ANY drug is bad and that you should be clean of all drugs no matter what. This is not an attitude that AA as an organization shares, in fact, it explicitly encourages members to seek outside professional medical and psychiatric help if needed, including taking prescribed medication. Unfortunately, I think a pretty broad swath of the public believes the same thing–that being dependent on a prescription for your well-being is somehow weak and wrong. But tell that to a diabetic who takes insulin, or the chronic pain sufferer who takes opioids, then tell it to this girl, who listened to this ignorant woman, went off her meds, and killed herself about a month later.
I've experienced the shaming and ignorance many times, and was once let go from a music project partly because someone said I was "not really sober" because I took prescribed psychiatric medication for Major Depressive Disorder. It is the dangerous attitudes of people like that, and people like the misguided woman at the AA meeting that contribute to the deadliness of addiction.
Both the broader medical community and public turn a blind eye to the plight of those in chronic pain, and the majority deny that their inevitable opioid addictions are a progressive, potentially fatal disease worthy of compassion, treatment, and medical resources. Resources like treatment with the drug Suboxone (aka Buprenorphine), which is a narcotic used to treat opiate addiction for not only heroin addicts, but the chronic pain sufferer, whose treatment relies on opioids to live their lives. They aren't asking for addiction. It's a side effect of their treatment and it can be lethal. The man who found Prince in the elevator wrote about the limited access to Suboxone both in Minnesota and the nation in treatment for opioid addiction.
Prince's pain management treatment, like so many others, had led to long-term physical dependence on prescription painkillers, which in turn evolved into an addiction, which he was actively seeking help for. What's the difference between dependence and addiction?
According to the National Institutes of Health:
Physical dependence can happen with the chronic use of many drugs—including many prescription drugs, even if taken as instructed. Physical dependence in and of itself does not constitute addiction, but it often accompanies addiction. This distinction can be difficult to discern, particularly with prescribed pain medications, for which the need for increasing dosages can represent tolerance or a worsening underlying problem, as opposed to the beginning of abuse or addiction.
Addiction—or compulsive drug use despite harmful consequences—is characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal.
It's not like some people get addicted to these drugs and others don't. Anyone taking them for longer than a few days becomes physically dependent on these drugs. That, right now, is the best the medical community has to offer for chronic pain management.
To me, addiction-shaming is akin to rape victim-shaming. Both inhibit disclosure, reporting, and ultimately, getting help. In one case, it allows the perpetrators to accrue more victims, and in the case of addiction, accrue more casualties. Ignorance has a price, and too often, it is someone's life. Every derogatory comment made about Prince for his chronic pain and addiction is like another nail in his coffin, or the next friend, or the next brother, or sister, or son, or daughter.
According to the National Institutes of Health, the cost of substance abuse costs the US more than $700 billion annually in costs related to crime, lost work productivity, and health care. It's not going away. Prescription drug use has the second fastest-growing use rate among 8th through 12th graders. (Marijuana is number one, and I'd be curious if that had more to do with access and legalization rather than a growing trend.)
So more kids are doing it, more people are dying, it's costing us more money, yet so many intelligent people I know roll their eyes at calling addiction and alcoholism a disease, or dismiss 12-step recovery groups as cults, or leave negative comments about a dead rock star who asked for help on his last day on earth.
I'm sorry Prince is gone because he was a musical genius and masterful performer. But I am more haunted by the prospect of what a world with a sober Prince in recovery might have been like. Maybe he'd be an advocate for the need for alternatives in chronic pain management, or the need for access to addiction treatment. Maybe he wouldn't talk about it, maybe he'd stay "anonymous," but maybe people would see that recovery is possible. Maybe they'd start to have compassion for people suffering with the afflictions instead of calling for their incarceration and damnation. Maybe they'd speak up when someone was ranting cluelessly about someone else's addiction.
I don't know. But I'm still here somehow, and I don't stay quiet, or anonymous, because I'm happy to be sober and wish more people got to experience it. That's just me, and though I am sometimes criticized for it, I know that my life was transformed when I stopped living in shame and silence about my medical disorders. I hope that if there's anything to learn from Prince's unnecessary death, it's that we could all use a more open mind and some compassion when discussing someone else's problems. As Prince said, "It's a hurtful place, the world, in and of itself. We don't need to add to it. And we're in a place now where we all need one another, and it's going to get rougher." I agree.
Maureen Herman, author and musician, is currently writing her first book, It's a Memoir, Motherfucker on Macmillan's Flatiron Books imprint, due out 2017. She was the bassist of Babes in Toyland from 1992 until 1996 and from 2014 to mid-2015. She lives in Los Angeles with her amazing daughter. She's also known to be activist-y.