Dan Diamond is the author of "POLITICO Pulse," the must-read morning briefing on health care politics and policy. He's also the creator of PULSE CHECK, the popular podcast that features weekly conversations with some of the most interesting and influential people in health care.

When pop star Prince died in April 2016, a gaggle of health care researchers and reporters—including me—tried to see the silver lining in his surprising, opioid-linked death. If even Prince, a famous teetotaler with access to the best medical care could end up addicted to painkillers, surely that would show that the opioid epidemic was reaching every corner of America. Maybe in death, his celebrity could illuminate the high stakes of the crisis and force a reckoning.

We were very wrong. More than 55,000 Americans—rich, poor, famous and not—have since died from their own opioid overdoses. The latest data from the Centers for Disease Control and Prevention suggest that the death rate in 2018 could be even worse. And Friday night’s news that rock star Tom Petty died from his own preventable painkiller overdose, more than a year after Prince, underscores how far there is to go.


In health care, there’s a quest for celebrity patients—a symbol who can galvanize change. It’s a strategy that’s worked before. Ryan White, a teenager in the 1980s, became the face of HIV/AIDS and helped drive research and reforms. More recently, actor Michael J. Fox raised awareness of Parkinson’s disease; Angelina Jolie’s op-ed about her breast cancer risk spurred a spike in genetic testing.

That hasn’t really happened with painkiller deaths, perhaps because there are too many famous faces to pick from. Actors like Heath Ledger and Philip Seymour Hoffman. Musicians like Prince and Petty. And it’s far from a new trend. Even Elvis Presley, who died 41 years ago, was dealing with painkiller addiction.

A celebrity’s death from painkillers also has lost its ability to shock and awe. “No one is surprised when they hear about a rock star dying of a drug overdose,” said Andrew Kolodny, an addiction expert at Brandeis University. “In some ways, it reinforces the stigma around addiction or that it only happens because of a certain lifestyle. Of course, that’s not true at all.”

Prince and Petty, for instance, were both dealing with chronic pain—like millions of everyday Americans—and seemingly got hooked on drugs in their attempts to manage it. Petty’s family said he played 53 concerts while using legally prescribed medication to deal with a broken hip; his death was reportedly an accidental overdose of a mix of those legal drugs.

The details of Prince’s death remain less clear, but investigators note that he had apparently overdosed just six days earlier, after a performance, and was administered an emergency recovery drug—a worrying sign of the depth of his addiction. He also had been hiding a mix of different painkillers in aspirin bottles, with at least some of those medicines apparently prescribed to his bodyguard for privacy. Prince had suffered ankle and hip problems for years, with multiple reports that he’d undergone major hip surgery.

Neither celebrity was blind to the risks. Petty had previously beaten a heroin addiction; Prince was scheduled to meet with an expert for painkiller treatment the day after he died.

“Prince was not a drug abuser” in the traditional sense of celebrity rockers, Kolodny stressed. “He was a religious guy. He was a vegetarian. You couldn’t smoke pot or drink alcohol on tour with him.”

But there’s a deeper reason why a celebrity death hasn’t arrested the opioid crisis: The problems are systemic and too entrenched to be shaken by a few high-profile victims. About 91 people now die from opioid overdoses every day, the CDC says—a conservative estimate—thanks to a potent mix of stigmas, addictions, lack of awareness and inadequate access to care and prevention.

“Too many people still think it’s a moral failing,” said Regina LaBelle, a drug policy official in the Obama administration. “Too many doctors don’t screen for or recognize addiction, so we have too much untreated addiction.”

The opioid epidemic has also made some pharmaceutical companies very rich, a real barrier to getting the industry to buy into change. Sales of prescription opioids almost quadrupled from 1999 to 2014 as the number of prescriptions soared. By 2010, there were more than eight opioid prescriptions for every 10 people. Purdue Pharma, the makers of OxyContin, have sold more than $25 billion worth of the drug in the past decade.

Meanwhile, more than 250,000 people died from opioid overdoses in the past decade. Some projections say that could double in the decade ahead, under worst-case scenarios.

It’s a public health crisis that largely unfolded with little attention, and perhaps that’s one way that a celebrity death can help: The news of what killed Petty will trigger another round of articles about the epidemic, an issue that the media largely missed for years. While a July 2001 New York Times magazine article was the first at the Gray Lady to frame the opioid problem in terms like “crisis” and “epidemic,” it wasn’t until 2014 that the Times began routinely using that shorthand.

Beyond raising public awareness, increased media coverage has real resonance in Washington, by forcing politicians to reckon with an issue. And many congressmen also ignored opioid issues until the past few years, focusing their health care advocacy instead on political issues like the Affordable Care Act or more traditional causes like cancer. The last White House wasn’t much better.

“President Obama neglected the epidemic,” Kolodny said, noting that the Obama administration’s flurry of activity—which included a surge in funding for opioid-specific issues, from virtually no dollars to $1 billion—didn’t come until the last of Obama’s eight years in office. Obama didn’t even publicly address the opioid epidemic in front of a live audience until an October 2015 town hall in West Virginia.

Kolodny was among the advocates pressuring the Obama administration to do more, warning Obama that he’d be remembered like Ronald Reagan for failing to acknowledge a public health crisis that unfolded on his watch. In Reagan’s case, that crisis was HIV/AIDS. (And interestingly, it was a celebrity—actor Rock Hudson—who’s credited with helping the Reagan administration make its first tentative steps toward addressing HIV/AIDS issues.)

But Kolodny says he’s even more pessimistic about Donald Trump, who, despite making repeated proclamations about the need to solve the opioid epidemic, hasn’t steered new funding to the problem and has even sought to cut resources. POLITICO reported this week on the Trump administration’s plans, for the second straight year, to gut the nation’s drug policy office.

“It would’ve been very easy for Trump to do better than Obama on opioids,” Kolodny said. “But in terms of action, he’s even worse.”

Beyond the Oval Office, however, there are signs of change—and not because of celebrity deaths, but because of new pressures on what gets prescribed and when. The first-ever surgeon general’s report on addiction, released in 2016, devoted hundreds of pages to unpacking the crisis and issued dozens of recommendations, including how physicians could better manage patients’ pain treatment. Prescriptions are down from their peak, although there are still enough opioids being prescribed that every American could be medicated around-the-clock for three weeks, the CDC says.

There’s also been a surge of scrutiny on how the crisis unfolded. The Sackler family that owns Purdue Pharma was the target of two penetrating profiles last fall, in the New Yorker and Esquire. The company took out a full-page advertisement in the New York Times last month touting its efforts to fight the crisis and not-so-subtly seeking to shift blame elsewhere, seemingly to substance misusers.

There’s much more to be done, and it may require average Americans to mobilize, en masse. “We need an ACT UP movement of pople in recovery,” LaBelle added, citing the activist movement that helped drive reforms to treat HIV/AIDS. “It’s beginning but [there’s a] long way to go.”

So, will Tom Petty’s opioid overdose drive any significant change? Will it lead to that outpouring of momentum? It’s far too early to say, but in the hours after the rock star toxicology report was released on Friday, a familiar drumbeat began, led by fans and family who wanted Petty’s death to be as meaningful as possible, under the circumstances.

“We recognize this report may spark a further discussion on the opioid crisis and we feel that it is a healthy and necessary discussion,” said a statement from Petty’s relatives, retweeted by White House opioid adviser Kellyanne Conway and many others. “We hope in some way this report can save lives.”