America Needs To Get Its Head Out of the Sand on the Opioid Epidemic

America has a long history of rewriting its own history. While this practice is sadly nothing new, perhaps one of the greatest real time showings of it in my lifetime has been the false narrative being spread like wildfire around the “opioid epidemic.”

It goes something like this: Johnny is from a white middle class community. He had everything going for him - was a great kid, star athlete, nobody ever thought of him as somebody who would use drugs. Johnny was prescribed narcotic pain medication by an irresponsible doctor peddling a nefarious pharmaceutical company’s wares. Unknowingly, Johnny got hooked and eventually moved onto using heroin. If it weren’t for that evil prescription he received, none of this would have happened.

Now, I must first acknowledge that legitimately prescribed for medical use opioid prescriptions are at the beginning of the addiction story for a small number of people - between 0.2 and 8% of people to be exact. So what about all the rest? What about the overwhelmingly much larger number of people who develop an opioid use disorder? Why don’t we hear their story being told in the tale of the opioid epidemic?

For myself and most people I have met who are living with or in recovery from an opioid use disorder, the addiction story started long before or in lieu of the false narrative of legitimately prescribed opioid use. For most, substance use or misuse was already taking place long before opioids entered the scene. And also for most, the introduction to opioid use wasn’t through innocently received prescription opioids but rather an intentional seeking out or use of them for the very purpose of “getting high.” While the media and now even policy makers would have you believe that most people started off innocently with a prescription prior to “getting hooked,” it is just not the reality and is not backed by the evidence. It is not the truth for 3 out 4 people with an opioid use disorder.

So why does this false narrative continue? Why is now narrow, short-sighted and ineffective policy being formed around this false narrative?

Well, for one, there is far less shame in the popular narrative of the opioid epidemic being told from the lens of victimization at the hands of bad doctors and pharmaceutical companies. There is also far less shame in leaving out the alcohol, tobacco, marijuana and other drug use that most often precedes opioid use. To acknowledge that those we thought would never become addicted to drugs were already on the path that could lead to it would require taking our heads out of the sand. America has long struggled with the shame of looking honestly at itself in the mirror. America has long had difficulty with looking at its shortcomings that are fertile ground for addiction to spread such as poverty, unemployment, underemployment and unequal wealth distribution, unaddressed mental health concerns and trauma, for-profit and political lobby-strong healthcare, discontent with a lack of access to the “American dream,” disconnection from community, poor education systems, unstable or unsafe housing, etc.

So yes, there is truth in there being some irresponsible doctors as well as greedy pharmaceutical companies who capitalized in our capitalist society on not only our physical but our collective emotional, mental, social, environmental and economic pain. But the doctors and pharmaceutical companies are not the larger problem here. We do not have a prescription opioid problem so much as we have an addiction problem in America that, when it comes to the opioid epidemic, escalated with ease of access to legally manufactured opioids in primarily white and middle or higher income communities. But to be frank, we are lying to ourselves and to each other when we pretend that the opioid epidemic is borne out of simply an ignorant access to legitimately prescribed opioids. It is just not the truth for most.

If this country is going to make any real progress on addressing the opioid epidemic, we need to get our heads out of the sand. We need to stop spreading, feeding into and believing the false narrative that this all simply started off with legitimate, for medical use prescription opioids when for most and in the context of the American climate, it started off as a way to numb non-physical pain and escape internal and external conditions. The opioid epidemic is no different than the crack epidemic in that way. It is time our country starts looking at and telling its truth.

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