Adrenaline is used as a tool by management to ensure artists can perform while in pain or while ill.
Adrenaline and the World of Celebrity
What is adrenaline?
Adrenaline is a naturally occurring hormone that the body produces in times of stress, fright or nerves. The body creates a fight or flight response to stressful stimuli and when the body produces adrenaline it causes your heart rate to speed up and your breaths to quicken. It’s produced by the adrenal gland in the body and pumped through the bloodstream.
Adrenaline can also cause a person to respond in ways that they would normally be unable to do. If you’ve ever seen Twilight, where Edward says to Bella, “I had an adrenaline rush. It’s quite common. You can google it.”
This was in response to Edward stopping the car, which would be physically impossible, but adrenaline rushes are one of the body's vital defence mechanisms and can enable the person to respond in a way they may otherwise not have been able to. For example, someone who’s been injured during an adrenaline rush may not feel the pain until much later once the adrenaline rush has gone, so they could walk with say a broken leg or fractured femur, but later be in agony.
Adrenaline is also produced as a medication and has been used for many years as an aid to increase vasodilation and reduce the effects of severe allergic reactions. It is also used in the medical field as an aid to the CPR of patients who are having a cardiac event.
As such, it should always only be given to patients who are able to be monitored in hospital and should be used sparingly, as a last resort.
However, it has come to light in recent years that musicians are being subjected to abuse in the form of adrenaline injections when they are too ill to perform to ensure that the concert continues and that they are able to perform.
Many artists have come forward regarding the abuse they have suffered at the hands of an unforgiving music industry, but some of the most worrisome of all to me as a healthcare professional is the use of adrenaline that is unsupervised.
This is a highly dangerous and, in fact, a criminally negligent abuse of power as the side effects of adrenaline use are many and there are contraindications for use which the ‘doctor’ and I use that term loosely, may or may not be aware of.
The effects of Adrenaline:
According to the British National formulary, which all UK medical professionals must adhere to before administering any doses of medication to a patient, states that the use of adrenaline (epinephrine) is monitored to ensure that it is being administered correctly and that current best practice guidelines are being followed. There should be something similar to the BNF in most places around the world that regulates and controls the use of any prescribed medications to ensure patient safety and the secure use of the medications.
Adrenaline has both alpha and beta responses. An alpha response is vasoconstriction (narrowing of blood vessels) and a beta response of increased heart rate and increased contractility of the heart.
Blood vessels then act to send more blood to the brain, making your brain more alert, raising your blood sugar levels, possibly increasing your pain threshold and increasing air entry into your lungs and bloodstream.
Adrenaline can also increase your blood pressure and heart rate as it stimulates cardiac activity.
This as you can see appeals to record labels, managers and possibly artists themselves who are unaware of the risks or side effects of the use of Adrenaline as a stimulator for concerts. Increasing an artist's tolerance to pain for example can lead to them putting off surgery that their body desperately requires and can actually lead to long term physical damage of their body as the pain is still there; it’s just masked by the excess adrenaline in the bloodstream.
Record labels and managers have used this to ensure artists finish their contractual obligations before allowing them time off for surgery which is both horrifying and abusive.
Another way in which record labels and managers use adrenaline is to get stars who are too sick to perform onto the stage as the effects of the adrenaline would last anywhere from one to two hours and this would be enough time to have an ill singer able to perform on stage.
The use of adrenaline and other medications on artists by medics on their team isn’t closely monitored, however this has to and should change as there are many, many risk factors involved in using medications in ways that they were not intended for.
In using adrenaline in this way, these medics are putting artists at risk from many side effects and damaging them in ways that could affect their long-term outlook and health outcomes in the future.
Adrenaline use can cause:
- Dizziness
- Vision Changes
- Tachycardia (fast heartbeat)
- Bradycardia (slow heartbeat)
- Irritability
- Tremors
- Insomnia
- Poor appetite
- Vomiting
- Dry Mouth
- Reduced blood flow to the brain
- Cold extremities
- Headaches
- Restlessness
- Chest Pain/ Angina
- Pulmonary Oedema (excess fluid in the lungs)
- Heart Attack
- Stroke
- Cerebral Haemorrhage
- High blood pressure
- Anxiety
And if the use is prolonged over a period of time it can cause:
- Metabolic acidosis (The build-up of acid in the body due to kidney disease or kidney failure)
- Renal necrosis (a disorder of the kidneys in which all or part of the renal papillae die)
- Tachyphylaxis (rapidly decreasing response to a drug following its initial administration)
These are all side effects that can come from the use of adrenaline, but using this unmonitored on celebrities is disturbing and quite frankly dangerous and could potentially be fatal.
Any administration of adrenaline therefore should be monitored as soon as possible after the drug has been administered, however this cannot possibly happen if the artist is dancing around on a stage in front of thousands of people. One has to wonder what it’ll take for artists to be respected as human beings? Will it be when one of them collapses on stage and suffers a stroke, brain haemorrhage or myocardial infarction (heart attack), or can we change this now to stop this from happening?
Frankly we are lucky this hasn’t happened before now and there are other avenues to consider here as well. Medics are regulated, as are nurses, so what gives these medical staff the right or the authority to abuse patients in this way? It goes completely against the code of nursing and the GMC (The UK doctors governing body). Our loyalty as healthcare professionals should be first, and foremost to our patients, not to the managers or music labels which is why this is so baffling because at what point do the morals/ ethical guidelines of these professionals get put aside?
To care for artists on tour you must be contracted by the label/ management and are there to protect the health of the acts, but does it go further than that? There are apparently no special licenses needed and there are clinics in LA that cater only to celebrities which is understandable due to the increased requirement for privacy, but there is a downside to this celebrity culture of behind closed-door medicine.
If you look at when Michael Jackson died, his personal doctor came under fire and was eventually charged with his murder for giving Jackson access to medication that eventually caused a heart attack. This also happened in the case of Elvis Presley where his personal doctor came under fire for the star's death.
There are also many other stars who have died of accidental overdoses when they are mixing medications that shouldn’t ever be mixed, such as Brittany Murphy and Heath Ledger which comes back to the doctors because they should be warning their clients about the dangers of interactions between certain medications and ensuring that their patients are safe from the risks of accidental overdose.
Many celebrities suffer from drug/ alcohol addiction and many others suffer from anxiety, insomnia and other mental health related illnesses, but one has to ask if these are caused solely by the lifestyles they are living or is it something more insidious? Is it something related to the use of adrenaline? Is this affecting their health, their throats and voices and is that why artists are dying so, so young in comparison to others of their age? Is it the strain of their lifestyles touring and the high levels of stress and abuse they put their bodies through touring?
Adrenaline overuse can damage the heart muscles and your body overproducing adrenaline or suffering long term levels of stress can cause many health problems and can cause heart attacks, heart disease, high blood pressure and strokes, so it’s not a long-term solution and is something that definitely needs more examination and more stars to come forward about.
Artists are abused in so many ways in the music industry, with crazy touring schedules, ridiculously long days and putting their bodies through insane workouts/diets to keep looking good, so how long can we let this abuse continue? We’ve lost so many stars already; to addiction, to heart attacks and to suicide, and allowing this hidden medical practice and unlicensed professionals giving artists medications that should be monitored encourages labels and management companies to continue to abuse artists. How long will it be before we stand together and say enough is enough?
Is a person's worth really down to how much money they can make a record label or are they worth more because they have families, friends, loved ones and are we as the general public, consuming the music that these amazing people put out really only interested in them in as much as they can give us back, by touring, by putting their bodies through extreme stress over and over again? Can we look beyond the persona that the labels sell to see the person underneath and fight for their right to be treated with dignity and compassion, or are we too selfish to stop for a minute and consider that artists are humans too and may need to reschedule a concert due to illness?
Artists are already overworked, undervalued and forced to perform when sick, when in actual physical pain, through holidays and miss family events to bring joy to our lives.
Isn’t it time music labels and management companies stop abusing and taking advantage of our favourite artists and start valuing them as more than just a dollar sign?
Artists are human beings first and foremost and should be treated by everyone involved in their careers and lives as valuable and precious. It’s time for labels to step up to the plate and put the artists first instead of the money they can make from them, but I suspect we, as a society have to rock the boat more, before this actually happens.
So, let’s keep the pressure on and highlight that abusing artists is not now, nor will it ever be okay. Forcing sick artists onto stage isn’t okay. Abusing artists by making them take adrenaline injections is wrong and celebrities are more than their art. It’s time they were respected and protected by their teams instead of exploited by them.
Just a little food for thought…
Behind The Curtains
References
https://bnf.nice.org.uk/drugs/adrenaline-epinephrine/
https://www.medicines.org.uk/emc/files/pil.3675.pdf
https://bnf.nice.org.uk/drugs/adrenaline-epinephrine/
Virtual Medical Centre <Drugs > Adrenaline Injections
https://www.medicines.org.uk/emc/product/6284/smpc#gref
https://www.reviewofophthalmology.com/article/the-truth-about-tachyphylaxis
https://www.medicalbag.com/home/features/practice-prognosis/doctors-to-the-stars/
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