The California addiction doctor summoned for an emergency consultation with Prince runs a posh clinic that treats opioid addicts with acupuncture, Chinese medicine, yoga, and even surfing.
But he’s also a pioneer in the practice of using alternative opioid medications — drugs that may also be addictive but less so than Vicodin or heroin — to treat opioid addiction.
Dr. Howard Kornfeld was summoned by a representative for Prince to come to the musician’s Minnesota estate on April 20. He was not immediately able to travel, so he put his son Andrew on a red-eye flight to meet Prince and explain what treatment at his clinic would entail, according to Minneapolis attorney William Mauzy, who is representing the Kornfelds.
“The plan was to quickly evaluate his health and devise a treatment plan,” Mauzy said. “The doctor was planning on a lifesaving mission.”
In his backpack, Andrew Kornfeld brought the drug Suboxone, a prescription opioid painkiller that’s similar to methadone and is used to combat painful withdrawal symptoms. Mauzy said he had intended to give it to a local physician who was scheduled to see Prince.
He never had the chance.
Andrew Kornfeld discovered Prince’s body in an elevator on the estate, Mauzy said. It was he who called 911.
Andrew Kornfeld, who is not a physician but has undergraduate degrees in neuroscience and psychology, works in his father’s clinic as a “practice consultant.” Among his duties: teaching surfing to younger patients “as part of an individualized treatment plan,” according to the clinic website.
Howard Kornfeld has a strong reputation among addiction specialists.
“If I had someone in my family who needed to be treated, Howard is who I would call,” said Dr. Corey Waller, an addiction specialist from Grand Rapids, Mich., who has known Kornfeld for years. “If Prince could have seen him, he would have gotten the best medical advice there is.”
Waller praised Kornfeld for conducting studies and putting a focus on hard science and data in addiction treatment. He described Kornfeld as a compassionate physician who will be hard hit by Prince’s death. “He’ll dwell on this. He’ll be frustrated and say, why wasn’t I there?”
Waller said Prince’s death highlighted how stigmatized addiction is. “He had to call this expert from out of state to come see him in the dark of night,” Waller said. “He should have been able to go to the ER and get treatment.”
Located in Mill Valley, a charming redwood-and-celebrity-studded enclave in wealthy Marin County in Northern California, the Recovery Without Walls clinic has an active practice that includes treating teens addicted to prescription painkillers. It even offers a “Beat Your Addiction” summer program designed so teens can return to school drug-free in fall.
The outpatient clinic has a Marin hippie vibe: Treatment includes all sorts of alternative healing modes, including nutritional support and Chinese medicine. “Patients are encouraged to discover their own internal healing pathways,” the website reads.
Patients needing intensive treatment can be lodged in a private home or “a local boutique hotel” while “Experienced Personal Recovery Assistants” minister 24-hour care, the website promises.
Kornfeld did not return calls seeking comment, and STAT was unable to determine the cost of treatment at the clinic. Recovery Without Walls “does not take insurance and is not cheap,” said one positive Yelp review. “But there is no price to re-setting your body and mind.”
For all the frills, it’s the drug buprenorphine that appears to be at the heart of Kornfeld’s approach to addiction treatment.
Kornfeld has repeatedly told interviewers that he believes the drug, sold under a variety of names including Suboxone, Subutex, Zubsolv, and Bunavail, is effective in treating both chronic pain and withdrawal because it’s less likely to cause euphoric highs or overdoses and because withdrawal from it is gentler than with opioids.
“You’re not going to be roaming the streets in six or eight hours looking for another fix,” he told a reporter for his local paper, the Marin Independent Journal, in 2013.
“It’s useful and lifesaving,” said Dr. Herbert Malinoff, who runs a clinic called Pain Recovery Solutions in Ypsilanti, Mich., and has been prescribing the drug since 2002. He noted that the drug does not “treat addiction” but rather treats withdrawals and cravings, which allows patients to be more successful in kicking their addiction. “It’s not a treatment for addiction, it’s a tool,” he said.
Malinoff has known Kornfeld for years and said “he’s a well-thought-of physician.”
Former patient Tony Pernicone credited Kornfeld with breaking his addiction.
“No question he did wonders for me,” said Pernicone, 65 an art dealer and appraiser from Marin County who was treated by Kornfeld in the early 2000s. Pernicone was taking a high load of painkillers — up to a dozen Roxycodones a day — after a series of surgeries for kidney stones and other ailments. Kornfeld successfully weaned him off the drugs using Suboxone.
“When I met with him, he was seen as a rebel of sorts. This treatment wasn’t being used in hospitals or anywhere,” Pernicone said. “He was the only one I could find that was using it. Most pharmacies didn’t even carry it. You had to special order it. It was absurd.”
Though he’s off the painkillers, Pernicone still checks in with Kornfeld. And the addiction doc stepped in to work with Pernicone’s other physicians after he had surgery for colon cancer to make sure the painkiller addiction would not return.
“He was involved with all my doctors, getting all their reports,” Pernicone said. “He’s a mensch.”
Kornfeld’s passion for using drugs in addiction treatment is catching on: In search of ways to curb the opioid crisis, President Obama has proposed aggressively widening the use of methadone and buprenorphine to treat addiction.
The White House wants to double the number of doctors certified to prescribe buprenorphine and is even considering allowing non-physicians to prescribe the drug.
“Millions of people have opioid abuse disorder,” said Waller, who serves as legislative chair of the American Society for Addiction Medicine. “A lot of us are capped and have to turn away patients.”
The proposal to ease restrictions has raised concern, however, among critics who don’t like the idea of treating addiction by prescribing more addictive drugs. Critics worry that the treatments are being diverted to the black market. And they fear that the drugs are being too liberally dispensed, often by physicians without expertise in addiction.
Buprenorphine was approved by the FDA in 2002 but is heavily regulated: Until recently, it could only be prescribed by physicians who had taken an eight-hour course in use of the drug, and, at first, physicians were limited to treating just 50 patients with the drug. Physicians can now treat up to 100 patients and the Department of Health and Human Services is currently considering an increase to 200, but many advocates say the limits keep the drug from being used more widely.
Kornfeld has also said he thinks that the drug, a generic, is not being used widely because it is not a moneymaker for the pharmaceutical industry. “Pharmaceutical companies view the painkiller market as a huge potential market,” Kornfeld said in a 2013 interview. “They want to invent new drugs that can be patented.”
In addition to his private practice, Kornfeld in 2011 launched a pain management clinic at Highland Hospital, a public hospital in Oakland that treats many low-income patients. His goal, he said, was to reduce patient dependence on painkillers.
The use of Suboxone there worked well, according to Dr. Evan Seevak, director of ambulatory care for the Alameda County Medical Center, which runs the hospital.
“Dr. Kornfeld has enormous passion for this issue,” Seevak said in an interview with the Marin Independent Journal after the clinic had been running about a year.
In March, Kornfeld spoke at a session on psychedelic-assisted therapies and research, joining a panel discussing the use of psilocybin mushrooms and shamanic traditions in healing at a San Francisco gathering held by the California Institute of Integral Studies.
Kornfeld has also been a leader with Physicians for Social Responsibility: In 1983, he published a journal article about the nuclear arms race and urged fellow physicians to “help reverse this dangerous process.”
This story was updated to include comments from Dr. Corey Waller and from a patient of Kornfeld.