My patient, the addicted rock star.
Leaving active addiction behind and moving forward in life with a clear head can feel as exhilarating as walking out on stage in front of a cheering crowd. Yet, one of my patients knows how it really feels to be on stage performing to a crowd. He is an actual rock star.
During my visits with this patient, we have had some conversations about music. I love music and have had some experience myself with composing, performing, and even mixing and mastering audio tracks. In fact, one of the motivating factors for my starting a podcast was that I could go back into the studio and use my editing and audio mastering skills again.
Having the opportunity to speak to my patient, the musical genius, who has written and performed music that fans love to hear has led me to reflect on other musical geniuses in history who have struggled with addiction. When I was a teenager, I had a different view of rock stars than I do now.
Because of the hype and shroud of mystery surrounding the great rock artists going back to the 60s and 70s, I had a warped perception of who these people were. To be fair, much of the misinformation about musical personalities came from embellished stories told by high school friends.
I happened to be friends with a lot of hopeful future rock stars who played either guitar or drums. I had friends who wanted to be the next Jimi Page (guitarist, of Led Zeppelin) or John Bonham (drummer, deceased, also of Led Zeppelin).
Addicted rock stars are real people with real problems.
Some rumors about rock bands and their members probably had a some truth to them. For example, Ozzy Osbourne really did bite the head off of a live bat. Since Ozzy is still alive, having survived his addiction with a supportive wife, we are able to now hear this and other stories with a little more reality and less hype.
Ozzy did not realize that the bat was real at the time. He was performing in Des Moines, Iowa, coincidentally where I attended osteopathic medical school. He thought the bat was rubber. When he realized that he had bitten off the head of a live bat, he was rushed to the hospital for rabies treatment.
The bat incident occurred in 1982. Sometime in the mid-80s, probably a few years after the bat scare, I met Ozzy for a few seconds at an appearance in a local music store. We shook hands and smiled together for a Polaroid. He seemed like a genuinely nice guy, not some possessed, ritualistic live bat-eater.
So, growing up, I was given the impression by friends and acquaintances that many rock stars were mixed up in satanic circles and had made deals with the devil. Overdoses were somehow connected to their misadventures into the world of demons and evil spirits. To add to my misperception was the use of this popular narrative in television shows and films.
I don’t know if young people today have similar warped views of the bands that they follow. Now that we have the internet and resources such as Google, YouTube, and Wikipedia, there is better access to thoroughly vetted information, though misinformation certainly does get through as well.
Being open about addiction and mental health issues is cool now in the world of pop music.
It is reassuring to see some current music stars, such as Billie Eilish, speaking openly about serious and important mental health subjects, such as anxiety, depression, and body dysmorphic disorder. I recently heard Jerry Seinfeld, also a stage performer and “rock star” of comedy, speaking about how depression seems to go hand-in-hand with creative ability.
Unfortunately, rock stars of the past may not have felt comfortable opening up about issues of anxiety, depression, and addiction. They were victims of fame during a time when their handlers thought it better to feed their addiction rather than help them to confront it and treat it.
Even if early rock stars had wanted medical addiction treatment, the highly effective medication-assisted treatment protocols we have today were not around in the 60s, 70s, and 80s. Additionally, it is likely that many rock stars would still not go in for treatment, even if it was available to them.
Another issue discussed in the interview I listened to with Seinfeld was a reluctance to allow mental health conditions to be treated with medication. He agreed with the fears of other performers that his creative edge might be dulled by treatment with psychotropic medications, such as antidepressants.
It is possible that some rock stars, or the people in their lives, believed that ongoing misuse of addictive drugs helped to boost their creative abilities and performing skills. Of course, this belief often ended in tragedy.
Tragedy strikes a talented young rock star.
One rock star who has intrigued me lately is Bon Scott, singer for the Australian rock band, AC/DC. While he was the second singer for the band, his music writing and performing abilities led the band to breakthrough success from the mid-70s until his death in 1980 at 33 years-old.
My teenage impression of Bon Scott was probably that he was another drug-crazed rocker who died of an overdose. I would have imagined wild parties, destroyed limos and hotel rooms.
While these things may have happened, my impression of Mr. Scott changed after watching him perform on stage and speak in some interviews. Thank to YouTube contributors, we can watch these pieces of history and come to our own conclusions.
Bon Scott was born in Scotland. He moved with his family to Australia as a child. Mr. Scott was a seasoned professional performer and entertainer. He was originally hired by the band as a chauffeur and was then hired as lead singer after an audition.
Watching how he behaves on stage, he is professional in that he is not distracting during the instrumental sections of their songs. He does not attempt to upstage the band with dancing, or posturing.
And, when he sings, he has the look of a storyteller on his face, and he demonstrates an ability to infuse the songs with intensity, while at the same time, showing a sense of humor and playfulness. In interviews, Mr. Scott is intelligent and witty, having fun with his conversations with music reporters.
How did Bon Scott die? There are conflicting reports of the cause of death. His official cause of death is alcohol poisoning. Some people close to him claimed that he overdosed on heroin.
Could naltrexone have saved this rock star from death due to alcohol poisoning?
Four years after Mr. Scott’s death, in 1984, the FDA approved the drug naltrexone, which was first synthesized in 1965. Now, we have multiple protocols for using naltrexone to treat alcohol use disorder.
There is The Sinclair Method, a harm reduction treatment that involves starting naltrexone while the patient is still using alcohol. And, there are abstinence-based treatments, where either naltrexone tablets, or a monthly naltrexone injection are given to help a person who has quit drinking to not have alcohol cravings.
Would these treatments have helped Bon Scott to survive alcohol use disorder and continue a musical career that could have lasted decades? It is believed that some hit songs that AC/DC recorded after his death were written by him. Imagine how his musical compositions might have evolved over the years as he gained the wisdom of living a full life.
If, on the other hand, Mr. Scott’s drug of choice was heroin, there was already help available. Methadone maintenance was around since the 1960s. Unfortunately, the lifestyle of a rock star would not have been compatible with showing up at the methadone clinic every morning.
The approval of Suboxone and related buprenorphine-based medications by congress and the FDA would not come until two decades after Bon Scott’s death. Suboxone treatment is more compatible with the lifestyle of a rock star, requiring only monthly doctor visits. While there was also the option of Probuphine, the six month buprenorphine implant, this product has, unfortunately, been discontinued.
Would Suboxone have saved rock musicians who were addicted to opioids?
Jumping ahead in time to just a few short years ago, the artist Prince was discovered dead of an opioid overdose by a man who was apparently delivering Suboxone to him. This occurred in April 2016.
Why didn’t Prince go to a local Suboxone doctor? Why was this man, the son of a California addiction doctor, traveling by airplane, to Minnesota to meet with Prince?
Could Prince have gotten help from a Suboxone telemedicine doctor? Unfortunately, Suboxone telemedicine treatment had more restrictions in 2016. Since the pandemic started in 2020, the field of addiction treatment by telemedicine has opened up signficantly.
According to news reports, Prince was known to have been struggling with opioid addiction for some time, even showing up with an overdose in a hospital emergency room shortly before his overdose death. His family believes that if medication-assisted treatment for opioid use disorder had been started at that hospital, he might have survived.
Are there any evolutionary benefits to creativity?
Is intelligence and creativity an evolutionary dead end? I once read a fascinating science fiction short story that ended up with this conclusion, that human intelligence is an evolutionary dead end that will lead to the ultimate end of humanity. At the end of the story, more primitive primates, apes, inherited the earth from the overly-intelligent humans.
Is it possible that this is true of highly intelligent and creative people? Could the risk of mental health problems, such as addiction and depression mean that, without man-made prevention, creativity is a human trait that would eventually disappear as a useless, and even dangerous vestigial trait?
Recently, on a podcast, I heard the hosts discussing the evolutionary value of creativity. Their conclusion was that creativity seemed to be something that developed outside of evolutionary pressures.
While I agree that they may be correct that paintings and musical compositions do not provide survival benefit to a community, creativity itself is a very important trait for the successful propagation of the human species. In our modern age, we may wonder where the Mozarts and Bachs are, since no one has composed such beautiful, complex musical pieces in recent years.
What if the creative geniuses who might have composed music in the 18th century are now writing computer code and designing microchips? Or, maybe they are winning Nobel Prizes in physics, or discovering new ways to cure or prevent disease.
And, creative geniuses inspire other creative geniuses. For example, the music of Jimi Hendrix inspired Paul Allen, one of the founders of Microsoft. Albert Einstein was inspired by the music of Bach. Here are examples of creativity crossing over from the arts to science and technology.
Steve Jobs loved to speak, in his famous keynote speeches, of working at the intersection of the arts and technology. Creativity has benefits in many ways, whether expressed through work in the arts, technology, or science.
Musicians are at risk for addiction, but not for the reason that you might think.
Many people believe that there is so much drug abuse and addiction in the world of entertainment because of the high availability of drugs in that world. The problem with that explanation is that most people who are exposed to drug use do not become addicted.
You may be surprised to know that many people try powerful opioid drugs and do not go on to develop opioid addiction. The same goes for other addictive drugs, including alcohol, cocaine, and amphetamine. Even nicotine, the most addictive drug on the planet, does not hook everyone.
Yet, with the high levels of addiction in the entertainment world, there must be something else going on. Creative geniuses are at higher risk of becoming addicted. Because of their curiosity, the search for creative inspiration, boredom, self-treatment of depression and anxiety, they are at risk for trying the different drugs that are available to them, and they are at high risk of enjoying the effects and continuing on to becoming addicted.
The tragic case of a pop music star who couldn’t sleep without drugs.
What about Michael Jackson? Jackson overdosed on the surgery drug, Propofol, also known as “Milk of Amnesia,” because of its white, milky appearance and short term effects on the brain. For years, he suffered from extreme insomnia.
According to a documentary I watched about the Michael Jackson case, he was treated by an anesthesiologist while on tour. The board certified anesthesiologist described bringing full monitoring equipment along with him, as if he was preparing the music star for surgery, but only providing anesthesia, so he could sleep.
Later on, Mr. Jackson hired a doctor who was apparently less experienced in administering general anesthesia. Unfortunately, the lack of experience and proper equipment, and continued use of general anesthesia drugs led to tragedy.
Jimi Hendrix was another top music star who had difficulty getting adequate sleep. He died from an accidental overdose of sleeping pills. While medication-assisted treatment for addiction may not have helped in this case, modern sedatives and sleeping medications have a lower incidence of respiratory depression, making them safer than older drugs, such as barbiturates.
Another young rock star’s career cut short by alcohol addiction.
Another rock star that caught my attention similarly to Bon Scott was Keith Moon. I was aware that he was the famed drummer for The Who and he had died of a drug overdose. What I was not aware of was that his overdose was related to medical treatment for alcoholism. Again, unfortunately, his death occurred years before naltrexone was approved for use in treating alcohol use disorder.
Watching YouTube videos of Keith Moon in his prime of performing, he looks very young. While playing, he is smiling, playful, and cheerful. His band mate, Pete Townsend, seems to treat him like a son or younger brother. In later interviews, you can see the effects of alcoholism and possibly depression.
Watching these great artists perform live, recorded on film and now available for free online, we can see a creative spark in their eyes, before that light was dimmed by the effects of drugs or alcohol. These are people who were intelligent, creative geniuses, who could have excelled in any area of life.
In fact, they did climb to the top of the field of rock music, becoming worldwide stars. Unfortunately, the world of rock music was a serious danger to them, relentlessly consuming them until they had nothing left to give.
Similarly, there are other professions that are not recommended for people who are predisposed to addiction. On a regular basis, I recommend that my patients do not get jobs as bartenders or working in local casinos. There are jobs that put too many temptations in the path of people who must avoid being around drugs.
Addiction is a cause of death that could be prevented in many cases with appropriate medical treatment.
Unfortunately, in the world of music, the lives of many great contributors have had their lives cut short by addiction-related tragedy. I once heard a talk where the speaker recommended that we should stop recording deaths as having other causes when addiction is the root cause. He stated that we should call these deaths, “Death by addiction.”
While the world of rock and pop music was very different in past decades, there is no excuse for losing more great artists to substance use disorders. The recent death of Prince was a wake up call. Medication Assisted treatment had been around for well over a decade when Prince arrived at a hospital due to an opioid overdose.
Of course, the need for widespread medical addiction treatment goes well beyond the world of famous performers. There is a huge unmet need for modern addiction treatment in all states and all communities in the US.
One major problem that we face is that there is still significant stigma associated with addiction and other mental health conditions. Additionally, medication-assisted treatment for opioid addiction also has stigma attached to it.
Overcoming stigma will help us to move forward and make better use of the tools we have available.
Why is there still so much misunderstanding and suspicion surrounding proven medical treatments that have been around for decades? Why do people discourage their loved ones from starting and continuing life-saving medication-assisted treatment for addiction?
If you are having a difficult time overcoming addiction with abstinence-based treatments, consider the possibility that you are a potential rock star yourself. Maybe you are not a musician or stage performer, but you are likely someone with a high level of intelligence, creativity, and curiosity.
Imagine what you could accomplish if you could put down the drugs and get back to living again without the obsession and sickness. It would have been nice to have had all of those great rock stars still with us, performing and writing new music. The medical treatments we have available now might have helped many of them. Maybe medical treatment can help you to overcome your addiction and realize your dreams in life.