ROBERT SIEGEL, HOST:
Six weeks ago today, Prince died, and now there's confirmation of what killed him - fentanyl. That's according to the summary of a medical examiner's report that was tweeted today. Fentanyl is an opioid painkiller. You may have heard of fentanyl patches. A recent rise in the illicit use of fentanyl has led to an alarming rise in the number of overdoses.
At this point, we don't have any information about how Prince came to possess fentanyl or what form of it he had, but we wanted to better understand what this drug, so we've called on Leana Wen. She's an emergency physician and also health commissioner in the city of Baltimore. Welcome to the program once again.
LEANA WEN: Thank you - nice to speak with you.
SIEGEL: There was a lot of speculation that opioid painkillers may have been responsible for Prince's death. Are you surprised to hear that it was fentanyl?
WEN: Actually, I'm not surprised, and the reason is that we are seeing a dramatic rise in the number of people dying from fentanyl across the country. Certainly we're seeing this Baltimore City - that between 2013 and 2014, we have seen the number of people dying from fentanyl overdose increase by seven times - not 7 percent but 7 times.
When know that fentanyl is now being mixed in with heroin, and it's very dangerous because if people think that they're taking their normal amount of heroin but actually they're taking fentanyl, they're going to be overdosing and dying because fentanyl is many times stronger than heroin.
SIEGEL: Dr. Wen, is it an increase in illegally sold fentanyl, or is there a huge increase in prescribed fentanyl?
WEN: We don't know. We suspect that the reason is both that there is increased trafficking of fentanyl, but also we know that the prescription drug epidemic is affecting all of us across the country. And fentanyl - it does have a real medical purpose. It's used for pain management, but it also can be misused.
And I have, certainly in my medical practice, treated individuals who have overdosed from legitimate uses of fentanyl sometimes from misuse. People have put fentanyl patches that are supposed to be on their skin under their tongue, as an example.
And so it's very important to follow the instructions as prescribed by your doctor and never combine it with any other opioid medications.
SIEGEL: It was said that Prince experienced a very severe hip pain from all the very athletic dancing that he did all those years. If you had a patient complaining of that sort of thing, would fentanyl be an appropriate drug to prescribe?
WEN: I prescribe fentanyl for individuals who are experiencing acute, severe pain. Someone who just broke their leg needs their leg to be put back into place or a joint to be put back into place. We would use fentanyl for that purpose. If somebody is going to - or just had an operation and has extreme severe pain, we use fentanyl for that reason. Sometimes fentanyl is also used for the management of severe, chronic, ongoing pain as well.
But we also see fentanyl now being mixed in, as I mentioned, with morphine and with heroin. And fentanyl is many times stronger than than morphine, many times stronger than heroine.
In the hospital, if a patient is getting fentanyl, we would always make sure that we have the antidote medication nalaxone, also called Narcan, nearby, and that's something that we urge all of our - all of your listeners, certainly all of our residents here in Baltimore City - we urge them to carry this antidote medication as part of their medicine cabinet and first aid kit because that's one way to save someone's life who could be dying from an opioid overdose.
SIEGEL: The implication is that the risk of opioid overdose is extremely great and common in that case.
WEN: That's right, and people we've seen - I've seen - I've treated children who accidentally took their parent's or grandparent's medications. I've seen teens who think that they're experiencing with one substance and don't know. And it's so important for us to all dump all of our medications that we're not using, take it back to a prescription take back area but also learn to use nalaxone because it can save a life.
SIEGEL: Dr. Wen, thank you very much for talking with us.
WEN: Thank you.
SIEGEL: That was Dr. Leana Wen talking about the drug fentanyl which we now know was the cause of Prince's death in April. Transcript provided by NPR, Copyright NPR.