As the old rock song, Deja Vu, goes, "We have all been here before."
Once again the headlines are full of the unbearable news of another superstar's drug overdose. Once again, experts on addiction are rushing to use a celebrity death to draw down on the failures of the culture, law enforcement and the medical system to prevent another talented artist from ending up in an early grave due to substance addiction.
It was shocking when Prince was found dead, alone in an elevator, on April 21 at his Paisley Park compound in Carver County, Minn., outside Minneapolis. It was shocking when reports began surfacing that investigators were exploring what role painkillers might have played in his death and how he obtained them, since Prince had always prided himself on his healthy lifestyle.
Now it's official, and still shocking: Prince died, at age 57, of an accidental "self-administered" overdose of a powerful synthetic opiate, fentanyl, according to the Midwest Medical Examiner's Office in Minnesota, which conducted the autopsy.
So, once again we are asking: Why, after all the alarms sounding for decades, does this keep happening? Why is there a straight line from, say, Elvis Presley in 1977 to Michael Jackson in 2009 to Whitney Houston in 2012 to Prince Rogers Nelson in 2016?
Shame, stigma, denial, fear, profit, pain — all and more are being blamed for this mournful intersection of fame, money, addiction and death.
Even other celebrities sometimes miss the mark in understanding addiction, such as Kiss singer Gene Simmons, who had to apologize after he called Prince's death "pathetic" in an interview with Newsweek. "(David) Bowie was the most tragic (death) of all because it was real sickness," Simmons said. "(Prince's) drugs killed him. What do you think, he died from a cold?"
Some of those who have succumbed still speak to us, poignantly, from the grave. Scott Weiland, former frontman of one of the biggest bands of the 1990s, the Stone Temple Pilots, once said his life was a daily boxing match with his demons.
"I'm still on the verge all the time," he told USA TODAY in 2011, noting that he was always shadowed — at home and on the road — by a friend entrusted with keeping him sober. "I swore, of course, never to go back to heroin, but I never thought that alcohol would be the real nightmare that it actually is. And it's legal."
Weiland died in 2015, age 48, of a toxic mix of drugs, including cocaine, ethanol and the amphetamine MDA. He was open about his problems with addiction, even writing about it in his autobiography. He worked at trying to overcome his addictions, and he still ended up dead of an overdose.
But it is possible to recover, just not easy, says Jamie Lee Curtis, writing in an essay on Huffington Post last month that she could relate to the reports of Prince's "toxic" death, because she was once toxic, too.
"I, too, waited anxiously for a prescription to be filled for the opiate I was secretly addicted to. I, too, took too many at once. I, too, sought to kill emotional and physical pain with painkillers. Kill it. Make it stop," she wrote. "I, like all of you, mourn the passing of a great artist but I also mourn the passing of potential artists past and present, caught in this deadly vise."
For comedian Marc Maron, Alcoholics Anonymous helped save him from addiction, but it was still hard work.
"If you would have told me back then that I wouldn’t desire a drink or that I wouldn’t desire to do drugs at some point in my life, I don’t think I would have believed you," he said in Slate in 2013. "Even with therapy and A.A. it took me 26 years to get 14 years in a row sober. I was in and out, in and out."
Shame is a powerful incentive to deny anything is wrong, says addiction specialist Clare Waismann of the Waismann Method Treatment Center in Beverly Hills, specializing in treating opiate dependence.
"I believe one of the main causes of all these overdoses is the word 'addiction' carries negative connotations and associations ... as if addiction was a living, breathing entity caused by a lack of morals, lack of strength or a flawed character," Waismann says. "This stigma that society has created keeps the ones that need help alone, hopeless and ashamed."
The special problem for celebrities, says Paul Earley, an addiction-medicine specialist and medical director of Georgia Professionals Health Program, is that no one wants to say no to them, not even doctors.
"Everyone is star-struck; they have problems confronting and pushing a celebrity to get proper treatment," Earley says. "Physicians and friends feed their substance use to be close to the celebrity aura. And then the celebrity dies."
Plus, celebs could have more trouble in the recovery process, says Matt Torrington, an addiction-medicine research physician and on the staff of the Avalon Malibu substance abuse treatment center in California.
"It is challenging for a celebrity to attend group support meetings for instance, because of a lack of anonymity and fear of exposure," he says. "If (having) money is not an issue, they may never hit rock bottom and nothing stops them until finally, a tragedy occurs.”
Like Heath Ledger, Philip Seymour Hoffman, Corey Monteith, Amy Winehouse, Chris Farley, River Phoenix, Janis Joplin, John Belushi, Jimi Hendrix and, now, like Prince.
Thus, Prince becomes the latest emblem of a surging problem in America with prescription painkiller abuse, one that results in thousands of deaths each year, most of them unremarked in the media and mourned only by their own families.
Lessons can be learned, we are told by the experts, but will they? After all, they haven't so far.
"We need another Betty Ford," says Richard Blondell, who specializes in prescription opioid addiction at the University at Buffalo's medical school. When the former first lady announced in the 1970s that she was addicted to alcohol and painkillers, people sat up and listened because "she had the ear of people in power," he says.
"Sure, many have died before and many will die again, but those who have learned these lessons (parents of dead children) are not the ones who sit in Congress or state office and have the power to change the system," Blondell says.
Epidemics of deadly drug addiction are not new in the USA, says Timothy Huckaby, a recovering fentanyl addict and specialist in pain management and addiction medicine, and president of the Florida Society of Addiction Medicine.
"The sad truth is that this keeps happening because individuals and companies are making huge profits from exploiting a segment of our society that has a brain-reward circuit sensitivity to these brain-altering substances, and once they develop this powerful and often deadly disease called addiction, they have no ability to resist the exploitation," Huckaby says.
Torin Finver, director of the Addiction Medicine Fellowship at the University at Buffalo and a recovering cocaine addict, says there is hope (therapy and medications such as methadone, buprenorphine and naltrexone). But addiction is an illness centered in the part of the brain that drives instinct and leads to "manipulative" behaviors such as lying, cheating and stealing, which in turn leads to shame and guilt, he says.
"I think that celebrities and people in power, because of their smarts and prestige, keep the lies going longer," Finver says. "When they are finally found out and coerced, hopefully, into proper care, they are further along in their disease, and often even more difficult to treat."
