Prince, Percocet and opioids: What you need to know | McClatchy Washington Bureau

As investigators try to determine the cause of death for recording artist Prince, speculation has focused on his recent battle with the flu and the possibility that he may have suffered a prescription drug overdose the week before.

The iconic 57-year-old pop star was found dead in his Minneapolis-area home Thursday morning. His spokesperson said the star had been suffering from the flu. An autopsy was performed Friday, but toxicology tests could take weeks.

Celebrity gossip website TMZ reported Friday that after Prince’s final concert performance in Georgia a few days earlier, he was on a return flight to Minneapolis when his private plane made an emergency landing in Illinois after he became ill.

TMZ reports that emergency responders gave Prince a “save shot” – presumably of naloxone – to counter the effects of a possible opioid overdose from Percocet, a powerful prescription painkiller he reportedly had been taking after hip surgery several years ago.

Because opioids can depress respiration, which is also a common effect of the flu, the use of opioids by someone who’s sick with the flu could make breathing even more difficult, said Dr. Deni Carise, chief clinical officer at Recovery Centers of America, which plans to open seven new drug-treatment facilities.

“You add the symptoms of the flu, if it does affect their breathing and the strength that they have to fight back against something. Then you add an opioid at too high of a rate, which does slow your respiratory (function), that’s where you get this synergistic effect,” with each making the other worse, Carise said in an interview with McClatchy.

Opioids are a class of narcotic pain medications that include prescription drugs such as OxyContin, Percocet and morphine, along with the illegal drug heroin.

Opioids reduce the perception of pain by attaching to proteins in the brain called opioid receptors.

From 2000 to 2014, the rate of opioid overdose deaths increased 200 percent, according to the U.S. Centers for Disease Control and Prevention. And in 2014, 61 percent of U.S. drug overdose deaths involved opioids.

Recently, the CDC issued new guidelines that call for doctors to try less addictive painkillers, such as aspirin and ibuprofen, before prescribing opioids to patients.

The guidelines, which are not mandatory, recommend that opioids be prescribed mainly for short-term pain episodes of three to seven days.

Naloxone, an emergency drug that blocks or reverses the effects of opioid overdose, is routinely used by emergency responders to revive overdose victims. More and more states have recently passed legislation that allows retail pharmacies to sell naloxone without a prescription in order to curb overdose deaths.

Carise said an emergency landing would have been necessary even if Prince had received a shot or nasal administration of naloxone while in flight.

That’s because naloxone, which knocks the opioid off the brain receptors and keeps it from binding with others, works for only 30 to 90 minutes, depending on how much opioid is in the person’s system and how quickly they metabolize the drug.

“You may still have three or four pills in your stomach that haven’t even released the drug action yet. . . . Depending on how fast you metabolize, there’s a window in there where you could still have the (naloxone) wear off and the opioids come on,” Carise said.