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Sunday 22 July 2018

How fentanyl infected the music business

The synthethic opioid is 30 times stronger than heroin, and has killed Prince, Tom Petty and thousands more, writes David Browne

Prince pictured in 2015
Prince pictured in 2015

David Browne

'The road and the studio are the only places I've ever felt completely OK," Tom Petty told Rolling Stone last summer, explaining why he was launching one last gruelling tour to mark his 40th anniversary with the Heartbreakers.

But the roadwork wasn't easy for him. Petty spent the entire 53-date tour struggling with severe pain from a fracture in his left hip. He got through it with painkillers and used a golf cart to move around backstage.

Tom Petty in 2017
Tom Petty in 2017

"Tom was ill," said his friend Stevie Nicks. "He fought his way through that tour. He should have cancelled and gone home. But not Tom. He was going to go down that river."

In October, a week after the final date at the Hollywood Bowl, Petty was dead. The 66-year-old had accidentally overdosed, mixing a variety of medications. The one the Petty family blamed: fentanyl, is an extremely potent synthetic opioid 30 to 50 times more powerful than heroin. Despite having a previous history of opioid abuse, he'd been prescribed a fentanyl patch to help with his pain; in addition to that slow-releasing patch, two other, more dangerous, derivatives of the drug were also found in his system.

"Those are illicit," says Dr Nora Volkow of the US National Institute on Drug Abuse. "Those you get very likely on the black market."

Petty's family declined to comment, but his overdose in many ways mirrored Prince's a year and a half earlier. Prince was also taking the drug while dealing with a hip injury, probably stemming from decades of punishing live performances. Over the last decade, fentanyl was also a leading factor in the fatal overdoses of former Wilco guitarist Jay Bennett, 3 Doors Down guitarist Matt Roberts and Slipknot bassist Paul Gray.

Heroin vs Fentanyl
Heroin vs Fentanyl

In November, rapper Lil Peep died at 21 after taking a combination of fentanyl and Xanax.

"It is so crazy-strong," says Petty's daughter Adria, who is planning a campaign against fentanyl. "We really don't want this to happen to anyone else. We learned this is the worst feeling you can have: to lose someone you love for no good reason."

Beyond the music industry, fentanyl has emerged as the most dangerous new drug in a generation. Of the nearly 65,000 fatal opioid overdoses in the US in 2016 (the most recent survey), one-third were fentanyl-related, double the amount from the year before. The drug has surpassed heroin as the leading cause of overdose deaths, and new data shows that fentanyl overdose deaths jumped 30pc between July 2016 and September 2017.

Fentanyl was invented in 1959 to help cancer patients cope with intense post-surgical pain. These days, it's prescribed as a lollipop or a patch, which slowly releases the dosage through the skin, typically used for a few days after a major surgery.

Though illegal in pill form, black-market fentanyl pills have become common in the past decade. This happened in the US after doctors cut back on prescribing OxyContin in 2007, when its manufacturer was sued for misleading the public about the drug's addictive risks. Opioid users had to look elsewhere - and turned to heroin, which dealers started mixing with fentanyl for a faster-acting, more euphoric and addictive high.

A fatal fentanyl overdose can happen in barely one minute.

"The dose you require is minuscule, like a grain of salt," says Volkow. "A tiny difference in your content can mean someone dying. You need a very sophisticated lab in order to measure a concentration that would be safe."

The drug's potency can pose a chilling new threat for users: In a previous era, "someone would OD and you'd have time to soak them in a bath or keep them moving until they got to the ER", says Gene Bowen, a former road manager and founder of Road Recovery, a musicians' substance-abuse assistance organisation. "It's not the case now. In 20 minutes they can be dead."

Opioids have gripped the music business for decades - codeine and Percodan were among the drugs found in Elvis Presley's body when he died in 1977. But fentanyl's rise in music may be rooted in deeper trends. Artists are touring more than ever before.

"The stress of the road is very difficult, but that's where the money is," says Harold Owens, senior director of MusiCares, the Grammy-connected assistance program. "So they go on these long tours, and physically it's horrible. They're not eating right or taking care of themselves."

Many of those hard-touring acts - at or near what would be retirement age in other professions - are dealing with the long-term effects of life on the road.

"We're all older, and people are starting to have carpal tunnel and injuries from playing," says Bonnie Raitt, a recovering addict herself, who was forced to cancel part of her current tour with James Taylor - another former addict - due to health problems. "It's very difficult to not take pain meds."

Another former addict, David Crosby, who is now 76, says he tours out of necessity, "or else I will not be able to keep my home. I don't have any savings." He avoids taking pain pills for his bad shoulders for fear of relapse: "I carry [painkillers]. I have some with me. But I've had the same bottle for three years. That's how seldom I hit it."

Prince reportedly became addicted to Percocet after hip surgery in 2010. "Jumping off those pianos and speakers, that doesn't bode well for anybody," says keyboardist Morris Hayes, Prince's musical director from 1992 to 2012. "But it's not something he would talk about. If his head was on fire, he'd put a hat on it and keep moving."

Prince's friend Sheila E added, "He was in pain all the time, but he was a performer... You think about all the years he was jumping off those risers."

After Prince was found dead in a lift at his Paisley Park home in Minnesota in 2016, tests revealed an inordinately high amount of fentanyl in his liver and stomach. He had no prescription in his name for the drug, and thought he was taking Vicodin. While searching his home, investigators discovered a bottle with 49 black-market pills that tested as part fentanyl.

Experts say Prince probably didn't know what he was taking.

"I guarantee you that Prince wasn't saying, 'I'm taking fentanyl'," says Scott Bienenfeld, an addiction psychiatrist who works with musicians.

"The majority of my patients are pain patients, and someone gave them fentanyl as an add-on: 'You've taken OxyContin, now take this'. Most of these musicians, trust me, don't know it's laced with fentanyl."

These kinds of pills are cranked out in labs in China and Mexico and can be easily ordered online and shipped anywhere. Pills with fentanyl compounds - sold in the US on the street with names like Apache, Goodfella, Jackpot and Murder 8 - can be as cheap as $10.

"The drugs look exactly like legit pills or drugs that aren't cut with anything," says Adria Petty. "Victims have no idea they are ingesting fentanyl at all, or extremely high doses of synthetic fentanyl, 50 to 100 times stronger than legally prescribed fentanyl, which is almost guaranteed to be deadly."

In April, after a two-year investigation, Minnesota authorities announced no one would be charged in the death of Prince.

"There is no reliable evidence showing how Prince obtained the counterfeit Vicodin containing fentanyl," said Mark Metz, an attorney for the state.

"The bottom line is that we simply do not have sufficient evidence to charge anyone with a crime related to Prince's death."

Since then, Prince's family has launched a lawsuit against a hospital in Moline, Illinois, for failing to properly diagnose another overdose Prince suffered six days before his death, on what were likely the same pills that killed him.

But to date, prosecuting fentanyl deaths has been an uphill battle. According to Darrell Roberts, father of Matt from 3 Doors Down, his son suffered from back pain and anxiety and had surgery on his hand a decade ago. Prescribed fentanyl in 2010, he quietly took the drug for six years.

Before a trip to Wisconsin to play a concert, the guitarist, co-writer of their 2000 hit Kryptonite, picked up a 30-day supply of 75mg fentanyl patches from a pharmacy near his home in Alabama.

"I didn't know what fentanyl was, but I knew Matt had taken something," says Roberts, who had joined his son on the trip. "His demeanour had begun to slow down. He was real slow walking and looking down."

A few hours later, his son was found dead in the hallway outside their adjacent hotel rooms. One fentanyl patch was discovered on his body.

"Matt had some pain, but nothing to a level that would rise to fentanyl," says lawyer Joey Dumas who is representing the Roberts family in a civil suit against the guitarist's doctor for wrongful death. The doctor was found not guilty in a previous criminal case after a jury could not determine how much fentanyl in Roberts's system was prescribed and how much was illegal.

Similar questions surround Lil Peep, who died on his tour bus before an Arizona show last year after overdosing on Xanax pills that he was likely unaware were laced with fentanyl. The Arizona DEA is investigating the origins of his fentanyl supply.

Soundgarden singer Chris Cornell struggled with opioid issues before he died last year. His death - by asphyxiation related to a prescription for Ativan, an anti-anxiety drug - has prompted his wife, Vicky, to rally against strong opioids.

"The only way to address this is that doctors need to take an active part," she says. "It needs to be part of medical training. How are they getting it? In the case of musicians, they don't even have to buy street drugs. Too many doctors want to be 'rock docs' and be 'in' and make people happy."

Cornell has started the Addiction Resource Centre, a website dedicated to her late husband that aims to help substance abusers. The Petty family is working on plans, to be announced soon, to offer guidance to families and addicts.

In the meantime, musicians are learning to identify - and avoid - fentanyl. On tour in Florida a few years ago, singer-songwriter Todd Snider was looking for OxyContin to help with shoulder and back pain. The dealer didn't have any, but did give him a fentanyl patch and lollipop. Snider immediately felt the difference.

"All the other drugs wake me up," he says, "but this one knocked me out." He vowed to never use it again. "I really did get lucky," he says. "I dodged that one."

© Rolling Stone

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