As concert season begins, so, for many artists, does the physical pain that can result from dancing around onstage each night after prolonged periods of sitting on the tour bus. One increasingly popular form of relief: fentanyl, the dangerously potent, fast-spreading opioid that medical reports suggest contributed to the deaths of Tom Petty, Prince and Lil Peep in the last two years.
"Touring musicians are at a high risk," says Dr. David Sack, chief medical officer at rehab center Elements Behavioral Health. "A lot of the musicians that I have spoken with over the years got exposed to fentanyl because they were given it to manage pain — they had to perform, and this gave them good coverage. The problem was, no sooner were the patches available that people were learning to extract the fentanyl from the sponge inside the patch to shoot it up."
The risk is compounded by the "very migratory pattern of the musician" when it comes to illegal drug use, says Dr. Harshal Kirane, director of addiction services at Staten Island University Hospital in New York. "If the individual has a sense of how many bags of heroin they use in one city, that can vary dramatically in a neighboring community, let alone in another part of the country." (According to the Centers for Disease Control and Prevention, 77 percent of the increase in Northeast and Midwest heroin deaths since 2013 involved heroin cut with synthetic opioids such as fentanyl; fentanyl-overdose deaths doubled to 20,000 in 2016 over 2015.)
The Los Angeles County coroner recently attributed Petty's death last October, at 66, to "mixed drug toxicity" of several drugs, including fentanyl; his family acknowledged he "was prescribed various pain medications for a multitude of issues," including emphysema, knee injuries and a fractured hip that evolved into a full break. Prince died in early 2016 of an accidental fentanyl overdose; friends later said he'd had a lengthy addiction to pain meds. Lil Peep, the 21-year-old rapper, died in November, of a fentanyl and Xanax overdose, a medical examiner told TMZ. Singer Chaka Khan was luckier; after hearing the news about her longtime friend Prince, she checked into rehab in June 2016 for fentanyl addiction, her spokesperson told press at the time.
Dr. Kirane believes fentanyl patches, prescribed by doctors, are still relatively low-risk, but there are also less-dangerous pain medications, including methadone and buprenorphine; all should be used in tandem with counseling and doctor oversight, medical experts say.
Still, Thelonious Monster frontman and addiction counselor Bob Forrest, founder of Malibu recovery center Alo House, warns that fentanyl is "here to stay" and notes that "Tom Petty had great friends. He knew what was up and still he fell victim to this. It's so sad."