One fact of life that I have learned as I get older is that problems rarely have simple causes and equally simple solutions. When a plane crashes, it’s never just one single cause but a multitude of issues culminating in a crash. The same is true for the opioid crisis. We have seen the same media report claiming that over-prescribing opioids have led to the rise in overdoses and we have tried to restrict our way out of it ever since. Prescriptions for opioids are at an all-time low while overdoses are at an all-time high. Meanwhile, pain patients continue to be forgotten collateral.

In early March 2016, I threw out my back and suddenly what had been reoccurring back pain turned into constant pain. To this day, I have not had complete relief from lower back pain; I can only reduce it with opioids, namely Tramadol these days. I have used opioids many times without any issues, but if I was a story on local news, my never-ending back pain would be the tragic start of my inevitable addiction. Instead, I lived the trauma of being denied necessary medication for no good reason.

When the incident first occurred, I was given Vicoden and it helped. I remember asking for a lower dose because if I take too much I get a nasty headache, which is the reason I don’t worry about addiction for myself. Then suddenly in the spring of 2016, Governor Baker signs a bill restricting opioid prescriptions based on the 2016 CDC Guidelines for Opioids and I cannot get another prescription to relieve my pain. I have extremely high pain levels for my back, and yet I had to suffer untreated. I ended up leaving my job for disability and I still cannot work. After months of fighting the issue with my doctors, I received the diagnosis of a herniated disk and sent to a pain clinic. I have been on opioids ever since.

The time spent not properly medicated was hard enough, but when I finally did have access to my medication I kept coming across unnecessary hurdles, and frankly bullshit from pharmacists, just to get my prescription. The worst was when the pandemic forced a change to only using electronic scripts. Due to the rules around opioids, doctors had to prescribe each month separately and not as a refill. CVS would dump the second script and when I called asking for my refill, they told me the script did not exist and it was a problem with my doctor. Luckily I have an understanding pain clinic, but I ended up transferring my pain medication to Walgreens because I had enough gaslighting from certain CVS employees. Still, every time I fill my prescription, I get anxious something will come up and I will be forced to endure days without my pain medication. That is a constant fear I live with every time my pills get low.

My story is not the only one of its kind, but it is consistently ignored. News reports covering the addiction crisis cherry-pick stories that match the narrative of an “innocent” person getting injured and then getting addicted to opioids after surgery. All thanks to doctors duped by Big Pharma. Addiction is certainly a tragic reality and one I would never downplay. However it’s important to understand that addiction cannot simply be blamed solely on the substance they abuse, other risk factors are at play. Many people use addictive substances without issue. Furthermore, it’s well understood that addiction often occurs from drug diversion, such as a family member stealing from a relative with a legitimate prescription.

The reality is that addiction has risk factors such as terrible socioeconomic circumstances, mental illness, trauma, and even genetics. Exposure to opioids alone does not cause addiction, and there are many aspects of addiction that are ignored in favor of the familiar narrative around opioid addiction. It’s easy to blame pharmaceutical companies and doctors for this crisis, but we didn’t get here on the addictive quality of these pills alone. People are suffering and dealing with an illness, and that requires a far more complicated approach that restrictions can never address. This is why people continue to die.

A new tv show aired on Hulu called Dopesick, and full disclaimer I have not watched it, but it’s peddling the same story that the opioid crisis is the fault of Big Pharma pushing addictive pills. While media can write all the stories they want to match this narrative, the truth is not so simple. We are told time and again that it was doctors who overprescribed pain pills and if we just stop overprescribing the problem will stop. After over 5 years of the 2016 CDC Guidelines restricting prescriptions, overdose deaths have continued to rise while legal opioid prescriptions are at an all-time low.

I am not addicted to opioids, but I do understand addiction. Many in my family have suffered from drug or alcohol addiction. Meanwhile, I struggled with nicotine addiction; first with smoking and then with vaping. I understand the stigma, and I know what it’s like to lose people to addiction. It took many tries to quit cigarettes and vaping until finally, I tried a more modern approach — I used Chantix and I’ve been nicotine-free since.

What does a modern approach to drug addiction look like? New York City opened the first of its kind Overdose Prevention Center aimed at giving opioid users a safe place to inject and avoid overdosing. These places also provide information and resources for people who want to quit. However, because many consider addiction a moral failing of being unable to quit, these safe injection sites are controversial. If the goal is to prevent overdose deaths, then reason and statistics dictate that this approach is necessary. Unfortunately, people are usually more concerned with controlling addicts and not putting in the effort to actually help.

As stated before, the issue is complicated, but I do know that our unwillingness as a society to deal with addiction on a humane level plays a huge part in why these deaths continue to rise. We will never find our way out of the crisis if we keep using one narrative as the logic behind every attempt to deal with the problem. Dopesick just repeats the same tired tropes that demonize a medication that legitimately helps millions of people.

Recently, two states have ruled in favor of the pharmaceutical companies, and we need consider why that is. If you have surgery and then your child steals your pills and gets addicted, how is that the fault of the company and doctor that gave you the medication in good faith?

We need to start looking at the opioid crisis as a multifaceted issue with many causes. Addiction can never be resolved through restriction and overdoses will continue to rise. Addicts will suffer and pain patients will suffer because people who don’t know what it’s like to have chronic pain or addiction feel self-righteous about refusing to legitimately help us. We need new ideas based on science to battle addiction, and we need to treat pain patients with what actually works. Morals have no business dictating solutions for either addicts or pain patients. Science must rule the day.

When it comes to addiction and chronic pain, don’t accept the simple answer. Strive to see the whole picture and base solutions on what actually works.