Music and Mental Health Series: A frank discussion of substance use and abuse amongst musicians, Pt. 1

It is a fact that people use substances, both legal and illegal, for all sorts of reasons. Some are more socially acceptable while others are relegated to back rooms and locked bathroom stalls. All can have a positive or negative impact on a person and, if not used safely, can cause illness or death. Overdose deaths in Rhode Island have been rising in the last decade, with 434 Rhode Islanders losing their lives to accidental overdoses in 2022, according to data from RIDOH’s Office of the State Medical Examiner and RIDOH’s State Health Laboratories.

“We might not talk about it as openly as we probably should, but I think it’s fair to say people initially enjoy the effects of substances, that ‘liquid courage,’” says Kate Noveau, a licensed independent clinical social worker (LICSW) who has been practicing for about 20 years. She is currently director of behavioral health for a local hospital system and has been working with the RI Governor’s Overdose Prevention and Intervention Task Force. “Some substances aren’t inherently dangerous when used in limited amounts, and from safe sources, but I want people to understand the very real dangers of illicit substances in this state.” 

“After losing a good friend and local musician last year, I decided I had had enough of people, my friends, not having access to Narcan and basic information on substances, so I totally threw down on making sure people had access,” Noveau says when describing her mission. “During COVID, I organized a couple of events at the News Café in Pawtucket and offered Narcan overdose education to the community. We targeted musicians, venues, friends, and we had a huge response, with local news crews covering the event. I shoved Narcan in every hand that was open.” You can also get free Narcan at most fire stations in RI, and at any Motif event, where we partner with the Parent Support Network of Rhode Island to get Narcan and information out and about.

Musicians and substances are lumped together, stereotypically. They have the potential to act as a “social lubricant,” which can help bestow the courage to perform in front of a room full of people. They are more socially acceptable in musical circles and can become a bonding experience. They also can increase creativity and decrease inhibitions.

“There has always been a romanticization of musicians and drugs,” says Sean Patrick Carney of Structure Sounds. “I watched one of my best friends and bandmate slip into a heroin addiction that cost us the band and almost his life. As artists we spend our time 10 feet from a bar or two friends away from a rolled bill in the back room. I’ve seen too many friends lose everything. I’m glad the venues and community have made things like Narcan and testing accessible. We’re not all Keith Richards in the end.”

Despite all the perceived “benefits” of substances, both legal and illegal, overuse and misuse can lead to a number of other issues, including dependency, increased usage, and the disruption of relationships.

“Alcohol, for example, is a depressant,” Noveau explains. “One or two drinks you might experience pleasurable effects without too much impact, but heavier consumption can result in anxiety and increased stress. It slows down brain functioning, suppresses the central nervous system, and causes impairments in speech, unsteady movement, and inability to react quickly. It lessens inhibitions and contributes to poor decision-making.”

Noveau states that her biggest concerns revolve around cocaine, opiates, and pills because they are often cut with fentanyl, especially in this state. She warns not to buy pills off the street, as they may not be what is advertised. She wants people to understand the risks of the desired substance and to know when to reach out for help.

“In RI, 75% of overdose deaths involved fentanyl (preventoverdoseri.org),” Noveau says. “Most of the cocaine that has been seized in the state also tests positive for fentanyl. ‘Oxys’ and Percs’ people buy on the street – cut with fentanyl. Heroin doesn’t even really exist in RI anymore, it’s all fentanyl. Benzodiazepines (‘xani bars’) – cut with fentanyl. The counterfeit pill problem in RI is real. People buy pill presses online and are manufacturing pills that look identical to medications you might pick up from the pharmacy, but they are made in clandestine, unregulated labs with unregulated ingredients, and can be lethal.” 

Noveau’s push to educate individuals about Narcan has been relatively successful. She is pleased to report that venues and allies are more prone to carrying Narcan. She knows that there is still a stigma attached, but encourages venues to get “nalox-boxes,” which can be thought of as an AED (Automated External Defibrillator) for users that overdose.

“Many bars and venues in the state have it now,” she says. “I’m so pleased to see that people are more open to it now. Overdoses can happen anywhere and using Narcan will not do ANYTHING other than reverse an overdose.”

“I try not to let too much drug use happen in my establishments, so I don’t have any issues with that,” says a local venue owner, speaking on condition of anonymity. “On the off chance someone is in trouble due to drugs or overdrinking, I call 911 and get the ambulance.”

People are free to make their own life choices and should be free from judgment as long as they aren’t hurting others, although actions from addiction can cause harm to others. Noveau suggests that people take safety measures if looking to experiment with drugs, including never using alone, testing the substances beforehand, and always having Narcan on hand. Fentanyl test strips and other harm reduction supplies are available through Parent Support Network’s outreach team. 

“Break them up so that you get an accurate read,” Noveau urges when using test strips. “There might not be fentanyl in your entire pill or bag of cocaine, but if you break it up, it’s likely that it’s in there. It’s like the chocolate chip cookie: not every bite has a chocolate chip in it.”

Nouveau knows that help can seem extremely difficult to obtain to some people. Admitting there is a problem, finding resources and taking the steps to schedule appointments once resources are found can be a daunting task. Her goal is to let others know that assistance is available and mental health is a team effort.

“It’s important to know that there are resources out there,” she encourages. “You don’t have to do this alone. Folks in the music industry are a unique group, and we want them to have access to mental health and substance use services from people that understand.”   •

If you are looking for support, contact NoveauAssociates@gmail.com. For immediate help, call 988 (Suicide and Crisis Lifeline), 911, or go to your closest emergency room.