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Drug expert sent to Prince on 'life-saving mission'
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Editor’s Note: Andrew Kornfeld graduated from the University of California, Santa Cruz, in 2013. He studied neuroscience and psychology, and now works with his father at Recovery Without Walls, their addiction outpatient clinic in Mill Valley, California. He is a writer and is currently applying to medical school. The opinions expressed in this commentary are solely those of the author.
Story highlights
Andrew Kornfeld, who discovered Prince after his death, writes nothing can prepare you for the chaos of that moment
He says America needs medical interventions for opioid dependence and addiction more than ever
Kornfeld: What if such treatment had reached Prince?
CNN
—
As the media has duly noted, I am the “pre-med student” who flew out to Minneapolis to help Prince find the road to recovery but who ended up calling 911 instead. Sadly, we now understand from the medical examiner’s report that he died from a self-administered dose of the powerful synthetic opioid painkiller, Fentanyl.
I know many of you are eager for details; understandably, you want to know what transpired that day. Believe me, nothing can prepare a person to walk into such chaos and sadness. As I told the 911 dispatcher on April 21, those on the scene were distraught, which was why I was the one to place the call. But what happened has made me think, long and hard, about what steps we must take to prevent such entirely unnecessary loss of life.
Andrew Kornfeld
Courtesy of Andrew Kornfeld
From the beginning, my dad, Howard Kornfeld, MD, instilled in me a love for the way life works, in all its beauty and complexity. We spent our days together exploring Northern California’s mountains and oceans – the wonders of the place we call home. The evenings found us in a big comfortable chair, where we pored over images of cells and animals in the pages of a well-thumbed biology textbook. He taught me that health is the foundation to all else, in regard to human life.
Singer and songwriter Prince performs onstage during his Purple Rain Tour in 1984. The artist, who pioneered "the Minneapolis sound" and took on the music industry in his fight for creative freedom, died in April 2016 at age 57.
Richard E. Aaron/Redferns/getty images
Prince performs in New York in 1980. Prince won seven Grammy Awards, and earned 30 nominations. Five of his singles topped the charts and 14 other songs hit the Top 10.
Waring Abbott/Michael Ochs Archives/Getty Images
He performs at the Palladium in New York in 1981.
Waring Abbott/Getty Images
Prince at the Lyceum in London in 1981.
Andre Csillag/REX/Shutterstock
Prince and Apollonia Kotero in a scene from the movie "Purple Rain," which was released in 1984.
Michael Ochs Archives/Getty Images
Prince, seen here on set, won an Oscar for the original song score for the classic film.
Warner Bros/Everett Collection
Prince performs in New York in 1984. Controversy followed the singer and that, in part, made his fans adore him more. His 1984 song, "Darling Nikki," details a one-night stand and prompted the formation of the Parents Music Resource Center. Led by Al Gore's then-wife, Tipper Gore, the group encouraged record companies to place advisory labels on albums with explicit lyrics.
Richard E. Aaron/Redferns/getty images
Prince performs at the Joe Louis Arena in Detroit in 1984.
Mirrorpix/Courtesy Everett Collection
Prince performs live at the Fabulous Forum in 1985, in Inglewood, California.
Michael Ochs Archives/Getty Images
Prince in 1985.
The LIFE Picture Collection/Getty Images
Prince, circa 1985.
The LIFE Picture Collection/Getty Images
Prince performs live at the 1985 Fabulous Forum in Inglewood, California. He created what became known as the Minneapolis sound, which was a funky blend of pop, synth and new wave.
Michael Ochs Archives/Getty Images
Prince in the United Kingdom in the 1980s.
Michael Putland/Hulton Archive/Getty Images
Prince, circa 1985.
The LIFE Picture Collection/Getty Images
Prince in a scene from the 1986 film "Under the Cherry Moon."
Warner Bros/Courtesy Everett Collection
Prince performs in London in 1986.
Michael Putland/Hulton Archive/Getty Images
Prince performs in London in 1986.
ERMA/CAMERA PRESS/redux
Prince performs at London's Wembley Arena in 1986.
David Corio/Michael Ochs Archives/Getty Images
Prince in 1987.
CROLLALANZA/REX/Shutterstock/Rex Features
Prince performs at Wembley Arena in London in 1988.
NILS JORGENSEN/REX/Shutterstock
The singer's predilection for lavishly kinky story-songs earned him the nickname "His Royal Badness." He is also known as the "Purple One" because of his colorful fashions. He is seen here in 1990.
Graham Wiltshire/Hulton Archive/Getty Images
Prince performs in 1990.
picture-alliance/Newscom
Prince, 1990.
Rico D'Rozario/Redferns/getty images
Prince performs during "The Nude Tour" in Birmingham, United Kingdom, in 1990.
Mirrorpix/Everett Collection
Prince listens to the crowd during a 1991 concert.
Frank Micelotta/Getty Images
Prince performs at the MTV Video Music Awards in Los Angeles in 1991.
Frank Micelotta/Getty Images
Prince performs at the Globe Arena in Stockholm in 1993.
Scanpix Sweden/SIPA USA
Prince arrives at the Ritz Hotel in Paris in 1994.
Jacques Brinon/AP
A disguised Prince appears at a Virgin Records in London in 1995.
Tim Rooke/REX/Shutterstock
As dozens of singers perform "We Are The World" on the 10th anniversary of the African famine relief anthem, the artist formerly known as Prince stands sucking on a lollipop next to Quincy Jones at the American Music Awards in Los Angeles in 1995.
Reed Saxon/AP
Prince poses for a photo in Toronto in 1996.
Chris Wahl/iPhoto.ca/Newscom
Muhammad Ali pats Prince's head prior to a news conference where they were to announce plans for a benefit concert in 1997.
KARIN COOPER/ROGERS & COWAN/AP
Prince performs in 1998.
Wattie Cheung/Camera Press/Redux
A disguised Prince speaks at GQ magazine's third annual Men of the Year Awards in 1998.
MITCH JACOBSON/Associated Press
Prince, circa 1999.
WIREPIX/FPS/Newscom
Prince performs in Hong Kong on October 17, 2003. Prince's concert was the the opening act in a four-week government-sponsored music festival titled "Hong Kong Harbor Fest," aimed at boosting the image of SARS-battered Hong Kong.
ANAT GIVON/AP
Prince arrives with his then-wife, Manuela Testolini, for the 77th Academy Awards on February 27, 2005, in Los Angeles.
KEVORK DJANSEZIAN/AP
Prince at the 2005 NAACP Image Awards in Los Angeles.
Kevin Winter/Getty Images
Prince performs during a news conference for Super Bowl XLI in 2007.
Terry Gilliam/MCT/Sipa USA
He left his imprint on many aspects of popular culture, from film to movies to sports to politics. As the Minnesota Vikings prepped to take on the New Orleans Saints in the 2010 NFC championship game, Prince wrote a fight song entitled "Purple and Gold" to inspire his home team. The Vikings lost. He was the half-time performer at the Super Bowl in 2007 in Miami Gardens, Florida, seen here.
Jonathan Daniel/Getty Images
Prince performs onstage during the 2007 NCLR ALMA Awards.
Vince Bucci/Getty Images
Prince performs on the runway at the spring/summer 2008 collection fashion show by Matthew Williamson during London Fashion Week in September 2007.
Solo/ZUMA PRESS
Prince performs during his Welcome 2 America tour at Madison Square Garden in 2011 in New York.
Kevin Mazur/WireImage/getty images
American pop legend Prince is pictured performing on the final night of the Hop Farm Music Festival in Kent, United Kingdom, in 2011.
Simon Earl/Splash News/newscom
Prince performing at the Femoren on August 6, 2011, in Copenhagen, Denmark.
Jakob Jorgensen/Polfoto/ZUMA PRESS
Prince on stage with singer Mary J. Blige during the 2012 iHeartRadio Music Festival in Las Vegas.
Christopher Polk/Getty Images for Clear Channel
Prince presents the winner for Record of the Year to Gotye and Kimbra during the 55th Grammy Awards in 2013.
JOE KLAMAR/AFP/Getty Images
A year later, Prince performs during the 2013 Billboard Music Awards in Las Vegas.
Ethan Miller/Getty Images
Prince performs at the 2013 Skanderborg Festival in Denmark.
Christian Hjo/REX/Shutterstock
Prince is seen in the stands during the 2014 French Open in Paris.
Photo via Newscom
Left to right: Zooey Deschanel, Prince, and Jake Johnson in a scene from the TV show "New Girl" which aired in 2014.
Fox/courtesy Everett Collection
Prince speaks at the 2015 Grammy Awards in Los Angeles. Additionally, last year, Prince released the song "Baltimore," addressing the unrest after the death of Freddie Gray while in police custody. He performed at a benefit concert in the city and gave a portion of the proceeds to youth groups in Baltimore.
While I was finishing elementary school, my dad emerged as a pioneer in the fields of pain and addiction medicine, joining a cadre of physicians who utilized new, evidence-based practices for their opioid-dependent patients. A medication called buprenorphine was at the forefront of their work. Its efficacy in treating addiction has since been well-documented. Patients with opioid addictions have a significantly higher chance of survival when buprenorphine is part of their treatment.
Many people become addicted to opioid painkillers because they are prescribed them as treatment for chronic pain conditions. The media reported that Prince was one such patient. But, as media reports over the last several years have made clear, what begins as a “harmless” short-term prescription of opioids can turn into a long-term dependence.
I have Crohn’s Disease, an autoimmune disorder that afflicts the gastrointestinal tract, so I am no stranger to chronic pain. While I am extremely healthy now, during my sickest moments, and in the aftermath of multiple surgeries, there is nothing I wouldn’t have done to escape the agony. The millions of individuals who suffer from chronic pain are familiar with this sense of desperation. They run the gamut: your next door neighbors, the celebrities you read about in magazines at the supermarket checkout, and yes – Prince.
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His death was a tragedy beyond words. He was an inspiration to so many, and in the brief time I spent in Minnesota, I saw just how good a friend he was to those closest to him. In the weeks that have passed since April 21, I have thought about what might have produced a different outcome. What if his troubles could have been addressed effectively, and much sooner?
Unfortunately, the timely care Prince may have needed, based on the medical examiner’s report, has been difficult to obtain in Minnesota, and in many states in our nation. According to the Minneapolis Star Tribune, there are 120 buprenorphine prescribers in the state, roughly 2.2 physicians certified to prescribe the drug, per 100,000 persons – not nearly enough.
Right now, we need medical interventions for opioid dependence and addiction more than ever, because in the U.S. we’re losing 28,000 people every year – a number that would average out to 77 people daily – to opioid overdoses. In addition, evidence suggests that we must call into question the success of abstinence-only methods.
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Drug expert sent to Prince on 'life-saving mission'
When a user relapses after “going cold turkey” (the protocol in an abstinence-based program), and then takes the same dose that he or she previously tolerated, that dose may prove fatal. Treatment with buprenorphine instead not only diminishes the chances of overdose, but also reduces the likelihood that the patient will relapse.
I have learned from my father that when a patient is in withdrawal (especially from opioids or benzodiazepines, which reduce anxiety or sleep problems), he or she will experience intense physical symptoms, coupled with feelings of vulnerability and powerlessness. Because buprenorphine helps to eliminate the craving for opioids, and reduces the brutal symptoms, it can give the patient the opportunity to develop healthy life habits and healing behaviors, which can readily become entrenched.
Over the last two decades, the overwhelming scientific consensus holds that such beneficial brain changes can occur at any time in life. Harnessing the full potential of what scientists call neuroplasticity doesn’t happen overnight, and more research is required, but it is possible that part of buprenorphine’s success lies in its ability allow such neurological changes to take place.
As I make my plans to apply to medical school, my father’s work is foremost in my mind. As the Centers for Disease Control and Prevention has made amply evident in announcements over the past two months, we are going to be dealing with the fallout of the opioid crisis for decades. There will be legislative challenges, as well as stigma and misinformation to battle, as we inch toward a meaningful solution.
It is easy to find yourself caught in a web of pain, and difficult to escape. I know this. So do many of my father’s patients, treated with buprenorphine, who have mustered the energy and the courage to come join me as we paddle surfboards in the chilly waters off of Northern California’s coastline, the sunlight near the horizon interrupted occasionally as near-perfect waves roll in.
What if my father and had been able to reach Prince just a week earlier, like so many others we have helped take back their lives? Prince could have been here, standing on the beach beside me.
Editor’s note: This commentary was updated to clarify a passage on the danger of resuming the use of opioids, even at the same dosage, after “cold turkey” abstinence.