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Jennifer Matesa, writer on addiction: ‘Prince was out there on his own’

Prince
REUTERS/Mario Anzuoni
Jennifer Matesa: "Pinned pupils are the one sign of opioid abuse that a user can’t hide. Photos of Prince, even in low light, show that his pupils are pinned."

Last week, when the Midwest Medical Examiner’s Office released its official report, concluding that Prince had died of self-administered fentanyl, a powerful synthetic opioid painkiller, I recalled a conversation I’d had back in 2014 with Jennifer Matesa, blogger, recipient of a SAMHSA Voice Awards Fellowship, and author of “The Recovering Body: Physical and Spiritual Fitness for Living Clean and Sober.”

In our earlier conversation, Matesa had described her own addiction to fentanyl, and the long and painful process she endured to get the drug out of her system. Then, I paid a visit to Guinevere Gets Sober, Matesa’s popular recovery blog, where I read her personal and compassionate post about Prince, and I knew we had to talk. 

I gave Matesa a call at her Pittsburgh home earlier this week, and we had a wide-ranging conversation about my favorite musician’s dangerous addiction, his untimely death and about what may have motivated him to use opiates in the first place. The interview has been edited and trimmed.

MinnPost: What inspired you to write about Prince on your blog?  

Jennifer Matesa: As a creative person and a former addict, I have an affinity with Prince. Creative types tend to drive themselves past certain limits. Prince was a physically small man. He was smaller than I am. He spent the majority of his life jumping and dancing around on stage wearing high heels with a heavy guitar strapped on his chest. You can’t expect to do that for 30 years without damaging your body or injuring your psyche.

When Prince died in April, at first some people said he was taking Percocet [acetaminophen and oxycodone]. But when I read that they had to give him a save shot when his plane made an emergency landing in Moline, I said, “There was no way he was just taking Percocet. ... He was probably taking a single-entity opioid, and it was probably pretty strong.” I know my drugs.

MP: So you’re theorizing that Prince’s addiction started a long time before he died?

JM: I’ve read that he was on strong opioids for 25 or 30 years. If that’s so, that means that he probably produced most of the body of his work while on opioids. There are files of photos of him where his pupils are pinned (abnormally constricted). I’ve looked it up online and this goes way, way back. Pinned pupils are the one sign of opioid abuse that a user can’t hide. Photos of Prince, even in low light, show that his pupils are pinned.

MP: Clearly, I’m a deluded Minnesotan. I always thought that Prince was sober because he was famous for living such a clean lifestyle. I was sad for me to hear that he was addicted to opioids.

Jennifer Matesa
Jennifer Matesa

JM: I think it is interesting that you say that. What is the cultural prejudice that drives your unwillingness to think that your beloved artist could be a stone junkie? I don’t use words like “junkie” lightly. I used to call myself a junkie. A person can be addicted and still be an artist. They can be addicted and still be an amazing person.

MP: Are people ever prescribed fentanyl for hip pain? Could Prince have been getting the drug legally from his physician?

JM: Where he got the drug doesn’t matter. The fact is that Prince’s tox screen at the end of his life said that he had fentanyl in his bloodstream. He overdosed on fentanyl. That’s it. I almost overdosed on fentanyl a few times. It [is scary].

MP: How did you end up taking fentanyl?

JM: I didn’t start out with fentanyl. I have migraines and fibromyalgia. I started out with codeine during my pregnancy. Then, after I stopped breastfeeding, I switched to Vicodin [acetaminophen and hydrocodone]. When I went to a pain clinic in my hometown of Pittsburgh, I was given pure hydrocodone. Then I moved to OxyContin [oxycodone] and then eventually to fentanyl.

By 2005, I was on straight fentanyl patches. I was also given fentanyl lollypops for free. They would give you coupons to take to the pharmacy. I became addicted through my prescribers. It was a particular moment in medical history when physicians were prescribing opioids for all kinds of conditions.

MP: But fentanyl is so potent. I thought it was usually reserved for people who are actively dying.

JM: That’s not always the case in the United States. Once, when I was traveling overseas, I ran out of fentanyl patches. I went to a pharmacist, who said, “We only give those to people with cancer.” But in this country we give powerful painkillers like that to a lot of people who do not have a fatal disease.

Fentanyl is the most potent painkiller. You can’t start on it. It could kill you if you did. You’d have to be taking other opioids for a while first. It is pharmacologically different from other opioids. It is fat-soluble. That means it crosses the blood-brain barrier quickly.

That’s part of the reason that fentanyl deaths are increasing in this country. They are not nearly at the level of other opioid-based drugs like heroin, but they are happening. The Federal Drug Abuse Warning Network says that it is very hard for EMS personnel to get to fentanyl victims quickly enough because the drug works so fast.

MP: You just said you almost overdosed on fentanyl a few times. How did that happen?

JM: I almost overdosed on fentanyl because I took too much. I didn’t go to a hospital. I was lucky I survived. I abused my drugs. I was prescribed adhesive patches that were intended to be placed directly on the skin. But I got to a point where I’d cut my patches into small pieces and stick them to the inside of my cheek so the fentanyl would enter my system faster. I’d do this when I had run out of the drug for a few days before I could fill a new prescription. I’d be in withdrawal, and I figured out that it was a faster way to get the drug into my system.

When the drug entered my bloodstream that way, it would spike the levels in my blood. I clearly remember lying in bed at night and feeling that my breathing was slowing. I’d wonder to myself, “Is my body going to remember to breathe?” Sometimes I’d keep myself awake because I didn’t have a way to reverse the effects of the drug.

MP: This sounds frightening. What did it feel like?

JM: The feeling of respiratory depression is really scary. It is beyond your control. It is almost as if you are lying down and someone is stacking bricks on your chest. You can’t breathe. I am very fortunate that I didn’t die.

If you write in your column that I told you I cut the patch into pieces, make sure to say it can kill you. It is lethal.

MP: I know that this question may be going too far, but I’m still going to ask it: When you experienced that feeling of respiratory depression, were you ever at the point where you just thought, “Maybe I should surrender to this?” If you’d rather not answer, I’d respect that.

JM: Actually, it’s a really great question, because so many people are overdosing these days and a lot of the discussion about addiction is being driven around whether people who fatally overdose actually do it on purpose. I personally think that a lot or even most of these overdoses are accidents. People don’t actually want to die. They either have taken heroin that is spiked with a drug that is stronger than they thought it was, or they take an opioid with alcohol or a benzodiazepine and that makes it fatal.

Those few times when I experienced respiratory depression, I didn’t want to die. I had a young child and I wanted to stay alive for him. One of the reasons I got sober was because I wanted to be present for my son and for other loved ones in my life. Then, as I started to get better, I realized that I had things I wanted to do in life that might actually help other people and I needed to stay alive and sober in order to do that.

MP: You still suffer from migraines and fibromyalgia. How do you do to treat your pain now?

JM: I use exercise and meditation. I use appropriate diet. I use nonaddictive medication to get rid of the headaches. These are all things that I’ve written about in my book.

What I’ve tried to do to treat my pain is to take better care of my body. I have to understand my limits. I cannot dig in the garden for eight hours. I have to pay attention to my pain and take care of it and not just numb it.

MP: Do you think Prince was numbing his pain?

JM: How do I know what Prince was really doing? There are ways in which creative people get afraid that the creativity will someday leave them. That’s what drives the anxiety and sometimes the use. I know it worked that way for me.

MP: That sounds like a much bigger problem than straight-up addiction.

JM: In this country you are not supposed to suffer emotional pain. That is not the American way. We are supposed to have these easygoing, carefree lives. But every life comes with unhappiness and struggle. The way we get through that is community.

In the case of Prince, we’re talking about a person who had this really tough childhood, yet he had this extraordinary talent. Then he proves himself and then he becomes super-famous and wealthy. That is a recipe for isolation. What kind of community does a person have when he lives in a compound? What kind of web of love and trust and friendship does a person have when he is that famous and recognizable? In so many ways Prince was out there on his own.

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Comments (15)

Andy this was a great attempt

Andy this was a great attempt at an interview and a great chance for people to really understand the thought process and possible motivation behind opiod addicts. However Jennifer's answers were terrible and I gained nothing. There's never a need to get defensive or be a smart-ass when all you were trying to do is to get answers for your audience from someone who's been there and experienced the addiction that Prince was going through.

Keep up the good work Andy.

Exactly

I didn't appreciate her calling him a junkie either and trying to diminish him.

That last paragraph

…seems to me to be the key one. We're social creatures, and mountains of literature has been written about the pain and discomfort of loneliness.

It seems to me he chose to be out there on his own

Its as if the image he wanted to portray prevented from him asking for help and we need help to over come our addictions.

no

It was less about his "image" and more about the pervasive TMZ tabloid culture that he wanted to avoid.

Not quite...

Prince was painfully shy as a child, and lived his entire life in a form of isolation due to the very unfortunate circumstances of his upbringing. That isolation continued throughout his life, and fame only made it worse. It's very clear from the stories which circulate that he simply could not establish the types of "normal" human relationships that most people do quite naturally. Think about that for a moment.

It was because of this that he had no support network to step in when he really needed it, which is the point of Matesa's (somewhat cold) comments. But the fault for that must be spread pretty widely, and include the absent and abusive parents, the fawning staff, the awed collaborators, and even the adoring fans. You can blame Prince if you want, but he was clearly the victim here, albeit of circumstances which he either couldn't avoid, or actively cultivated in the empty hope of resolving issues that went back (literally) to his birth.

From an early age, fame seduced him as a possible way to right the wrongs he'd been born into, but it did the opposite, compounding them beyond the point that he could ever hope to recover. Prince's body died of a fentanyl overdose, but because no one was there to help him get the help he couldn't get for himself, he actually lost his life to the deep isolation of fame.

it does matter

"Where he got the drug doesn’t matter. The fact is that Prince’s tox screen at the end of his life said that he had fentanyl in his bloodstream."

Of course it matters where he "got" the drugs. Knowing whom supplied the drugs would help to prosecute anyone that aided him illegally.

No it doesn't...

Prosecuting someone won't bring him back and it won't stop the next celeb from getting whatever it is that they want. People with money and power will always get whatever it is that they want.

Not really fair

The statement about seeing "pinned pupils" in "files of pictures" as a clear indication of opioid use seems unfair since "pinned pupils" occur whenever bright lights are shown into our eyes - like say when a photograph is being taken.

I am not suggesting that Prince was perfect, or that I cannot accept the results of the autopsy, but at least be fair in calling "assumptions from a distance" just that.

Seconding This

I was stunned by Matesa's assertion that she could find evidence of "pinned pupils" in photographs going back many years. I assumed that, if this were true, others would also have noticed it as well. But after a little bit of research, hers is the only such claim that I can find.

So I checked around on what it means to have this look, and started looking at photographs myself. For one thing, Prince's very dark brown eyes often make it difficult to discern the size and shape of his pupils. For another, most readily accessible photos have been taken in artificial lighting conditions which would have had an impact on his pupil size. I couldn't really find any photos that meet the criteria of natural light and eye close-ups where the size and shape of his pupils could be determined.

In other words, I don't believe it's possible to reach that conclusion just from the photographic evidence. Some firsthand observation would really be necessary, and I cannot find reports from anyone who knew Prince and has come forward with such a claim. Of course, that doesn't meant someone won't, but I would have thought it would have been on the record by now. (There are claims from alleged "dealers" that his addiction was something more than anyone around him knew, but the credibility of these is yet to be established.)

This may sound like denial from a fan, but I looked because I really want to know. If there is such evidence, then it should become part of the inquiry, and part of how the fans understand the artist. It would actually explain a few things about his work ethic. It is relevant information. But I think Matesa's claim can't really be supported in the way she describes, and must be set aside until such evidence can be found.

(Her central premise, on the other hand, that he died as a result of isolation, is very much worth considering.)

Misinformed

I don't know where you come with such uneducated allegations. I have had serious issues with most excruciating pain for many years and have been on demerol simultaneously with Valium and ativan all prescribed in hospital as well as at home all scripts from same dr. When I moved and demerol was no longer working new doctor had me on same benzos with dilaudid for years. When I stopped taking dilaudid because it was no longer helping the pain I was not addicted and had no withdrawal symptoms whatsoever, and furthermore I was fully functioning normally no side effects nor have I ever felt anything other than out of pain , I wasn't sleepy nor any different mood and NEVER absolutely never a feeling of a high. Being of of dilaudid for years I was recently taken take very prestigious hospital by ambulance because such severe pain and hospitalized for days I was given i.v. of ativan with dilaudid so I don't know how people say the two kill you or it definitely makes you addicted or high. I've never drank nor smoked or used drugs of any kind recreational lyrics, but I will tell you that if you are in such severe pain and other health problems you do not have even a minute feeling of high while on very high doses of strong opiods, personal experience. And as medical problems needing high doses of benzodiazipine at the same time had absolutely no side effects that people say make you drowsy, and the combination if medically necessary obviously does not kill you

Consider the Long Term Possbility

Opioid Poisoning is not often noted in these cases, not meaning it was not at issue, however. Those who really want to know the underlying (perhaps progressive) nature of one little-known issue should review this condition.

Tissue biopsy results have not been released, so public information is scant. Why? Are there criminal investigations coming from systemic realities? So, everyone should read up on Opioid Poisoning in the meantime. My only leap to this possibility came from the brief interview with the Chef, who noted relatively recent but significant dietary changes to simpler and softer foods, including shakes and smoothies. Reports of debilitating acute stomach pain got my attention, as well.

Nobody has answered one critical question: What was the chronic source of all that pain, pain requiring emergency dosing and airplane landing in one instance? Those who simply want a bit of summary speculation here might like to know that opioid poisoning from long term legal use causes the tissue walls of the stomach and intestines to thin and become critically degenerative. Just think about those collateral consequences for a minute. Pain increases over time to the point where additional opioid dosing becomes a palliative in an incredibly vicious circle, as the stomach becomes impaired, then esophagus, leading to classic GERD (reflux) disorder. This is a very nasty way to die...slowly, painfully and without understanding.
It is no leap to imagine the convenient remedy: one large dose to end the pain, perhaps forever, intentionally or not.

I for one, very much want to know the tale the tissues told. Until this is clarified, I take the ME report to be pro-forma, revealing only proximate cause of death. What was causing all that pain??

Cause of pain?

Perhaps, Prince had esophageal cancer, the tale of the tissue would reveal that. The cause of stomach pain, sore throats,vomitting,flu like symptons the quick weight loss, all sound like esophageal cancer symptons, only the tissue would reveal the answers.Taking medication for the pain of the cancer,very possible. My brother had esophageal cancer,lost 80 lbs. in a matter of 2 months, couldn't eat anything solid only wanted soft food, smoothies, shakes and liquids, very painfull cancer.

Prince- opiod use

First of all "pinned Pupils" in his line of work could have been from lighting and not opioid use. Even if he was using opioids and was under a Dr.s care for years it was his own business. Calling him a junkie just because she was abusing her medication is uncalled for and inappropriate: handle your own guilt and b.s. in your own way. It's plainly clear in the pictures of him the last few years that he was not feeling well and had a change in health. She can't say that she knew that he had been using for years based on pictures that she's reading into or projecting her own feelings about. I think it's all just horrible, Prince would be horrified at what is happening. People should be ashamed at themselves!

Bad stuff

I really don't like the words and tone this person has used to answer the (more than legitimate) questions.

Too many allegations, ranging from ridicule (dilated pupils for a man who was always photographed under spotlights or flashes) to absurd (she read that he was addicted for 25-30 years? Where? The National Enquirer?).

Anyway, you can't call a guy a "junkie" because of some unconfirmed personal theory. I have my theory (Prince being addicted for some years because of hip pain?), but it's as much a conjecture as any other. I won't call him a junkie though, actually I think junkie has become so derogatory a word that we shouldn't even use it anymore.

I've know addicted people, my cousin died at 24 because of heroin addiction and she was the best person I ever met. Never thought of her as just another junkie.