Opioid Overdose to Blame for Prince’s Death

Opioid Overdose to Blame for Prince’s Death

According to officials in Minnesota, Prince’s death at the age of 57, on April 21st, 2016, was due to an opioid overdose. Prince’s autopsy was conducted by The Midwest Medical Examiner’s Office and they reported that the superstar died from self-administered fentanyl, which is a synthetic opioid painkiller [1].

 

The pathophysiology of an opioid overdose is the same regardless of whether the opioid was taken legally as a prescription medication or illegally on the street [2]. Heroin and prescription opioids, including oxycodone, codeine, hydrocodone, fentanyl and morphine, are classified as opioid receptor agonists, meaning they bind to opioid receptors in the pain pathways located in the spinal cord and brain. Additionally, they bind to the dopamine reward pathways in the brain producing euphoria and modifying reward circuit connections [2]. Due to the effect of opioid binding on the parts of the brain responsible for breathing, high doses can result in respiratory depression, and ultimately, death. A triad of signs and symptoms known as the “opioid overdose triad” can identify opioid overdose; this triad includes: pinpoint pupils, unconsciousness, and respiratory depression [3,4].

 

The risk of respiratory depression and death from opioid overdose is heightened in individuals that combine opioids with sedative medication and/or alcohol [3,4]. Further, if individuals combine opioids with a stimulant such as cocaine, the stimulant can mask the effects of the sedative and the individual may not realize that they’ve taken an overdose of opioids until the stimulant wears off, which can also lead to deadly breathing issues [1]. Another issue occurs with individuals who have gone through a period of abstinence, including those who were incarcerated or part of an in-patient detoxification treatment program. The period immediately following discharge from these facilities significantly increases the risk of fatal opioid overdose. The main reason for this is that these individuals use incorrect judgment with regard to dosing following the period of abstinence due to decreased opioid tolerance, resulting in fatal overdoses [4].

 

Fatal opioid overdose is a rapidly growing public health concern that can be combated through the use of naloxone, which is a safe and non-abusable substance that can reverse an opioid overdose once administered [4]. To reduce the number of opioid overdose fatalities, there has recently been a push to make naloxone more readily available to increase the chance of it being available when an individual overdoses, thereby helping to reduce the risk of death [1].

 

References

  1. Rettner R. Prince’s Death: Why It’s So Easy to Overdose on Painkillers. Live Science. 2016. Available at: http://www.livescience.com/54595-prince-death-prescription-opioids-lethal.html. Accessed June 15, 2016.
  2. Kathryn F. Hawk G. Focus: Addiction: Reducing Fatal Opioid Overdose: Prevention, Treatment and Harm Reduction Strategies. The Yale Journal of Biology and Medicine. 2015;88(3):235. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553643/. Accessed June 15, 2016.
  3. WHO | Information sheet on opioid overdose. Whoint. 2016. Available at: http://www.who.int/substance_abuse/information-sheet/en/. Accessed June 15, 2016.
  4. UNODC | Opioid overdose: preventing and reducing opioid overdose mortality. Discussion paper UNODC/WHO 2013. Available at: https://www.unodc.org/docs/treatment/overdose.pdf . Accessed June 15, 2016.

 

 

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