What Do We Know About the Drug That Killed Prince?

Following the revelation that rockstar Prince's death was due to an overdose of the painkiller fentanyl, the internet has been clamoring for more info on this prescription killer.

Fentanyl is one of the strongest opiate drugs on the market, 50 to 100 times more potent than morphine and 30 to 50 times more potent than heroin. It's also a “Schedule 2” drug, meaning that while it is used for medical treatment, it is known to have a high potential for abuse. Fentanyl kills by causing a severe respiratory depression or arrest, during which breathing is slowed or ceases altogether.

According to the Centers for Disease Control (CDC), it is frequently mixed with heroin, cocaine or both when sold illegally. Mixing fentanyl with street-sold heroin or cocaine markedly amplifies its potency and potential dangers. Effects include: euphoria, drowsiness/respiratory depression and arrest, nausea, confusion, constipation, sedation, unconsciousness, coma, tolerance, and addiction.

We don't know how Prince took the drug – the autopsy did not specify – but in a medical setting it would be administered via a lozenge, patch or injection.

Like heroin, morphine, and other opioid drugs, fentanyl works by binding to the body's opiate receptors, highly concentrated in areas of the brain that control pain and emotions. When opiate drugs bind to these receptors, they can drive up dopamine levels in the brain's foreward areas, producing a state of euphoria and relaxation.

Prince's death has created an awareness about the nation's growing problem with opioid abuse, both from prescription pills and illicit drugs like heroin. In 2014, more than 28,000 people died from an opioid overdose, which is more than any year on record, according to the CDC. Men are more likely to die from an opioid overdose.

According to data from the National Forensic Laboratory Information System, confiscations, or seizures, of fentanyl increased by nearly a factor of 7 from 2012 to 2014. There were 4,585 fentanyl confiscations in 2014. This suggests that the sharp rise in fentanyl-related deaths may be due to increased availability of illegally made, non-pharmaceutical fentanyl, and not prescribed fentanyl.

It's a problem, sure, but how can we fix it? One suggestion the CDC has is to expand the use of the drug Naloxone, an opiate receptor antagonist. These drugs act by blocking the effects of opiate drugs. Depending on state and local laws, this medication can be administered by EMS, law enforcement, other drug users, or family and friend bystanders who have obtained the medication.