Tom Petty’s autopsy: Fentanyl mixed with other meds led to accidental drug overdose

The tragic death of Tom Petty  October 2, 2017, was not from cardiac arrest as originally stated to the media.  Instead, a recently released Los Angeles coroner’s report confirmed that Petty’s death was the result of an accidental mixing of multiple pain medications.  The report released to the press stated, “Multisystem organ failure due to resuscitated cardiopulmonary arrest due to mixed drug toxicity.”

The family of Tom Petty had revealed that Petty had been suffering from knee problems, emphysema, and a badly fractured hip while still on tour.  On the day he died, he was told his hip had advanced to a full-on break. His wife, Dana Petty, and daughter, Adria Petty, stated, “It is our feeling that the pain was simply unbearable and was the cause for his overuse of medication.”

The sad end to Tom Petty’s life reminds us all of the dangers of accidentally mixing multiple medications or polydrug use, especially when opioids are involved in that mix.

The information released from the medical examiner’s report showed that the following drugs were found in Petty’s system at the time of his death: fentanyl, oxycodone, acetyl fentanyl and despropionyl fentanyl, all of them opioids.  In the United States, acetyl fentanyl, classified as a schedule 1 drug, has not been approved for medical use as there are no published studies on its safety for use in humans.  In addition to these drugs, Petty also had taken temazepam and alprazolam, which are sedatives, and citalopram, an antipressant. 

In 2016, more than 64,000 US citizens died from overdose from all drugs with more than 20,000 attributed to synthetic opioids, many of them related to fentanyl, the kind Petty had taken. 

Fentanyl may not be a household name like Oxycontin or Percocet, but this extremely powerful, synthetic opiate is not uncommon.  Introduced in 1960, Fentanyl, the same drug that killed singer Prince, is marketed under the brand names Actiq, Duragesic, and Sublimaze.  The original means of use for the drug was for palliative care for making the death experience painless.

By the 1970s is when Fentanyl was being abused recreationally.  Street names for Fentanyl or for fentanyl-laced heroin include Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, TNT, and Tango and Cash

Fentanyl is a drug to be handled with caution when prescribe to anyone.  It is 50 to 100 times more potent than morphine and 25 to 50 times more potent than heroin, according to the Levenson Foundation.  Classified as a Schedule II drug by the federal government, it is used medically for pain management following surgery or for chronic pain.  It is also sometimes used to treat patients with chronic pain who are physically tolerant to other opioids. 

As a physician, I warn against the dangers of polydrug use which is taking more than one type of drug, especially when opioids are involved.  The multiple mixture of drugs Petty had used at the time of his death, is a warning of just how dangerous merging different medications can be. 

For an example, let’s take a look at the life-threatening effect of combining opioids and benzodizapines.  Opioids, like fentanyl, are prescription painkillers.  Opioids bind with opioid receptors in the brain to stop a person from feeling serious pain by reducing pain messages from parts of the body to the brain.    

Benzodizepines, such as temazepam and alprazolam, two of the drugs Petty had in his system, are medications used to treat anxiety, insomnia, alcohol withdrawal, muscle tension, and seizures. They induce relaxation in the central nervous system allowing muscles to relax. 

Opioids and benzodiazepines are two of the most frequently abused prescription drugs in the world.  When combined, benzodiazepines enhance the effects or “high” of opioid painkillers, making this combination a bad mix leading to a high potential for abuse. If a person becomes addicted to opioid painkillers like oxycodone or Fentanyl, they can develop a tolerance over time so they do not experience the same effect.  But when these individuals add benzodiazepines to the drug cocktail, they can return to the same euphoric feeling they had the first time they abused opioids.  Unfortunately, this can result in a deadly combination leading to two primary problems – depressed breathing and enhanced sedation unless emergency medical assistance can intervene in time.

Sadly, the number of people who will die needlessly from multiple medication overdoses is not likely to reduce soon.  Losing musical talents like Tom Petty along with other lives lost to the grip of opioid addiction must end.

We are at a crossroads in tackling the opioid crisis. We are tired of losing loved ones and tired of hearing about this national drug crisis.

Slowly, change is happening. Changes are already being implemented which include minimizing prescribing narcotic painkillers, making it mandatory physicians have to look up a patient’s prescription history, provide easier access for opioid addiction treatment, and to start treating opioid addiction as a health issue and not as a moral failing or crime. 

Unless we make changes, nothing will change. All of us together can do our part in making these changes happen.  If we don’t, within time there will very likely be another headline of another famous person we lose to opioid addiction.