Below blog reprinted with permission from DoveMed. As a personal aside, my generation danced at junior high and high school dances to songs like “Little Red Corvette” and “Purple Rain”. While perhaps we thought performers like Prince and Michael Jackson were eccentric and “different” there was no denying their musical talents. As the below blog points out, deaths due to opioids is a significant public health issue that needs to be addressed.
The office of the medical examiner that performed the postmortem examination on the artist Prince released its results. The cause of death was listed as Fentanyl Toxicity and the manner of death was classified as accident.
A few months ago we wrote a blog on this website about the rise of opioid related deaths in the United States. The death of Prince will highlight the issue and as sad as it is it will bring about a much needed conversation on the topic of opioid related deaths, opioid consumption and overprescribing.
Death due to opioids has become an epidemic in the last years and as such it need to be addressed from a public health standpoint.
What is Fentanyl?
Fentanyl is a synthetic opioid (It is a manufactured substance) that is used for the treatment of severe pain or to manage pain after surgery.
Fentanyl is 100 times more powerful than Morphine and 50 times more powerful than pure Heroin.
How a person dies when using Fentanyl?
The mechanism of death of Fentanyl and all opioids is by inducing respiratory depression and respiratory paralysis, in other words it may slow down the lungs and decrease their capability of exchanging oxygen. It can also cause a sudden and complete stoppage of the lungs which will lead to sudden death.
Why the manner of death is accident?
The medical examiner has five options to classify the manner of death:
- homicide which means the death happened as a result of the action of other(s);
- Suicide, which means that death is self-inflicted.
- Natural as in cancer or heart disease.
- Accident when the person didn’t intend death to be the outcome and
- Undetermined when the certifier doesn’t have enough evidence to classify the death.
The manner of death as accident in case of drug related deaths is the standard as the user only intended to “feel better” not to die as a result of it.
Vast majority of drug related deaths are not true “overdoses” but idiosyncratic reactions to the substance or substances that were used. For instance the same amount ingested one particular day will make the person “high” and the same amount or less may kill the patient another day. That is the very reason that makes the use of substances such as Fentanyl extremely dangerous.
Unfortunately the death of Prince is not an isolated event. It is a type of death that is being seeing by medical examiners across the United States in increasing numbers the last ten years and it is affecting all strata of society.