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By: Robert G. Bell

Robert G. BellI remember the summer of 1984, watching “the kid” on the silver screen sear a riff with that Cloud guitar as he stepped to the mic and sang “I never meant 2 cause u any sorrow, I never meant 2 cause u any pain.” But the kid did cause us a whole lot of sorrow and a whole lot of pain. Now the kid is gone and can never explain, why we won’t ever hear you laughing or singing purple rain.

On April 21, 2016, one of the most talented musicians this world has ever seen, Prince Rogers Nelson, died of fentanyl overdose. The many years of touring and dancing in high-heeled boots left the musician with chronic hip pain that was managed with potent narcotic opioids such as fentanyl. Perhaps due to the chronic hip pain, Prince’s last tour was the Piano and Mic tour where his stage movements were a bit more subdued when compared to his previous tours, but the shows were powerful as well as unique as the music this man created.

Bell ImageThousands of loved ones, like Prince, die each year from opioid overdose. Opioid abuse and their associated deaths are considered an epidemic in the U.S. and other parts of the world. Prince died of an overdose of fentanyl, a powerful schedule II prescription opioid that is 50 to 100 times stronger than morphine. Fentanyl is typically used to treat patients to manage pain after surgery or to treat patients with chronic severe pain who are physically tolerant of other opioids. Too much of an opioid, especially potent opioids such as fentanyl, can depress respiration completely and lead to death. Now illicit fentanyl is once again on the rise.

As the crackdown on prescription drugs drove the cost of pills like oxycodone higher, the illegal drug cartels shifted their focus to heroin. It was cheaper, more readily available, and relatively easy to procure. It is even easier to procure fentanyl, which can be made in a laboratory without the need to grow poppies. Fentanyl has been known to be mixed into heroin (or cocaine) and cause death since the user is not aware of the potency of these street drugs.

A lifesaving therapy for opioid overdose is naloxone. If administered in a timely fashion, naloxone can reverse an opioid overdose. It has been reported that a week before he died, Prince was briefly hospitalized and received Narcan, a nasal naloxone spray. If Prince had Narcan on April 21, 2016, he would still be alive today and perhaps would be initiating an opioid step down program and considering additional traditional and alternative medical options for his hips.

And to those of us left behind, the grief can be unbearable. Like the grief associated with suicide, those left behind often feel we could have somehow prevented their death. These emotions are complex and bring on feelings of guilt, shame, blame, anger, fear, and isolation. To heal from this requires counseling, surrounding yourself with loved ones, and time. However, life will never be the same.

This is what it sounds like when doves cry.

Robert G. Bell, Ph.D., is president and owner of Drug and Biotechnology Development LLC, a consultancy to the pharmaceutical industry and academia for biological, drug, and device development.