Opioids Crisis in USA, Jim Morrison's possible OD

Overdoses are now the leading cause of death of Americans under the age of 50. According to preliminary data compiled by The New York Times, deaths last year likely topped 59,000 (19% more than the year before). More than 30% of Americans have some form of acute or chronic pain. Among older adults, the prevalence of chronic pain is over 40%. In 2014 alone, U.S. retail pharmacies dispensed 245 million prescriptions for opioid pain relievers. Of these prescriptions, 65% were for short-term therapy. More than a third (37%) of the 44,000 drug-overdose deaths that were reported in 2013 were attributable to pharmaceutical opioids; heroin accounted for an additional 19%. At the same time, there has been a parallel increase in the rate of opioid addiction, affecting approximately 2.5 million adults in 2014.

Opioid medications exert their analgesic effects predominantly by binding to mu-opioid receptors. Mu-opioid receptors are densely concentrated in brain regions that regulate pain perception (periaqueductal gray, thalamus, cingulate cortex, and insula), including pain-induced emotional responses (amygdala), and in brain reward regions (ventral tegmental area and nucleus accumbens) that underlie the perception of pleasure and well-being. This explains why opioid medications can produce both analgesia and euphoria. Mu-opioid receptors in other brain regions and in peripheral organs account for other common opioid effects. In particular, mu-opioid receptors in the brain stem are mainly responsible for the respiratory depression associated with opioid-overdose incidents and deaths. Opioids not only directly activate these brain analgesia and reward regions but also concurrently mediate a learned association between receipt of the drug and the physiological and perceptual effects of the drug — a type of Pavlovian conditioning.

Opioid medications vary with respect to their affinity and selectivity for the mu-opioid receptor, since some also bind to kappa- or delta-opioid receptors or to other neurotransmitter receptors and transporters. There is also considerable variation among the drugs with respect to their pharmacokinetics and bioavailability. When combined, these pharmacologic properties affect the rapidity of onset, potency, and duration of both the analgesic and pleasurable effects of opioids. The effects of opioids—particularly their rewarding effects—are accentuated most when the drugs are delivered rapidly into the brain. The rate of death from opioid overdose has quadrupled during the past 15 years in the United States. Researchers at the Centers for Disease Control and Prevention have estimated that 28,647 drug overdose deaths (61%) in 2014 in the United States involved some type of opioid, including heroin. Source: www.nejm.org

On August 3, 1966, the comedian Lenny Bruce overdosed on heroin in his Sunset Plaza Drive apartment. Bruce had been the cutting edge of American comedy in the posthipster, prehippie early sixties. He was an acerbic, shpritzing social critic who had been persecuted for the alleged profanity in his act. Bruce had been convicted of public obscenity in New York two years previously. Since then, Bruce had obsessively recounted his legal problems in his act and in print, becoming a gadfly critic of outmoded bourgeois morality. The cops hated him, and gleefully gave their grisly photographs of the death scene—Bruce had collapsed on the toilet, with his arm tied off—to the press. Lenny Bruce’s death bothered Jim Morrison.

Nico's 1967 album Chelsea Girl includes a track entitled "Eulogy to Lenny Bruce", composed by folk songwriter Tim Hardin. In it Nico describes her sorrow and anger at Bruce's death. Tim Hardin would die of a heroin overdose in 1980. Hardin had occasionally shooted heroin at Jim Morrison's bathroom in Alta Cienega Motel (Room 32).

Nico seemed to be forever "closing in on death," to borrow Lou Reed's phrase from "Heroin," the best song on The Velvet Underground album. She died of head injuries on the island of Ibiza in 1988, after falling off her bicycle en route to buy some hashish. Lou Reed was a ground-breaking artist; he liked to play off his sexuality as being “bisexual” or “homosexual”, but the truth of the matter is that Lou Reed was straight as a ruler. He used “alternative sexuality” as a marketing scheme, just a sign of the times when sexual identity was often manipulated for art and profit (David Bowie, New York Dolls, etc). With poetic brilliance, Reed just learned that you can 'tap the vein' without the drug. Nico was famous as a tragic beauty, the junkie Dietrich. She grew up as a rootless cosmopolitan - her passport read "ohne festen Wohnsitz", meaning no fixed address. Creem's Richard Cromelin memorably wrote: "If Morrison sang The End as a lizard, Nico is a sightless bird, lost but ever so calm, somehow knowing the right direction. She is the pure, dead marble of a ruined Acropolis, a crumbling column on the subterranean bank of Morrison's River Styx." 

At the end of an interview for Los Angeles Free Press, Jim Morrison gave his then definitive attitude towards narcotics. “There seem to be a lot of people shooting smack and speed now. Alcohol and heroin and downers – these are painkillers. Alcohol for me, cause it’s traditional. Also, I hate scoring. I hate the kind of sleazy sexual connotations of scoring from people, so I never do that. I like alcohol; you can go down to any corner store or bar and it’s right across the table.” In L.A. Woman Morrison had written for Pamela: “Hills are filled with fire. If they say I never loved you, you know they are a liar.” Shortly before her death Pamela Courson was awarded Jim Morrison’s share of The Doors’ publishing rights. In November 1971, Pamela had declared: “I declare that from the 30th September 1967 onwards I have always considered myself as being married to James Douglas Morrison, to all effects I was his wife and Jim used either the name Pam Morrison or 'my wife' when he introduced me to his various friends and acquaintances. All my bills for medical care, clothes or entertainment were made out to Mrs Morrison or Pamela Morrison. Both Jim and I made known to our relatives that we had contracted marriage in Colorado, explaining the nature of the Common Law Marriage that is law in that State. He always treated me as his wife; he has always taken care of me and I of him, just like a married couple. I swear this to be the truth.” Source: www.doorscollectors.com

Babe Hill, Jim’s closest friend and confidante between 1969-1971 said to Frank Lisciandro in Jim Morrison - Friends Gathered Together: "Pam could be a bitch to everybody, a little harridan. Was she trying to protect Jim or was she jealous? On the face of it she was an opportunist. She used Jim and his resources for her own ends, for whatever she wanted. But let’s face it, none us knew what went on behind that closed door between them two. It was a stormy love relationship, full of everything: acrimony, making up, the whole deal. When you come right down to it: they loved each other. And he definitely didn’t love another woman anywhere near as much. There was no one but Pam, and history bears it out: he was with her from the beginning to the end." Jim Morrison had briefly dated Nico but in a telephone conversation with his former UCLA colleague Dennis C. Jakob, Morrison confessed that Nico—despite her great beauty—wasn't really his type and he had found her very pretentious. Jakob remarked in his memoir Summer with Morrison: "I got the sense that what Jim found in Pam was a woman even more dependent than he himself had ever been. He had always had this strange dependency on women. Now he had found a woman who depended on him." 

One night Jim had a heated argument with Pamela at the Bag O'Nails nightclub after having known of Pam's affair with actor Christopher Jones. Pam said she wasn’t coming back with Jim unless he quit the Doors. He got drunk, insulted her, and apologetically started crying. She threw her drink in his face—a few people applauded—and stormed out. When some mutual friends reproached she had left him alone crying, Pamela replied nonchalantly: “Let him cry. He likes it.” According to Danny Sugerman, Pamela Courson told him that Morrison had died of an accidental heroin overdose, snorting it thinking it was cocaine. “Occasionally Pam used heroin but she wasn’t a regular consumer”, said Sugerman: “she used it when she was depressed, but she wasn’t a heroin maniac–she preferred barbiturates and tranquillisers.” After Morrison's death, however, “she lived in an imaginary fantasy world,” Sugerman adds: “she continuously flirted with death, carried on living her life in a risky manner.” James Douglas Morrison’s final notebook in Paris contained the harrowing message: ‘Last words. Out’. Also a chilling self-assessment: ‘Regret for wasted nights & wasted years–I pissed all it away–American Music’. Source: teamrock.com