Who is responsible for the opioid epidemic that America in general, and Staten Island in particular, is now wrestling with?
Many lives have been lost, and far more have been ruined. And certainly, the hunt for a culprit is only just beginning as the scale of the problem comes into sharp relief.
While speaking to people for my Pill Overkill story, it always started with me asking someone first – ‘who do you think is responsible?’
People then offered up all sorts of answers: many suggested the addicts who took the drugs were just paying for poor choices, or perhaps were weak enough to fall into addiction; others said we should blame the crooked doctors who wrote the unnecessary prescriptions for as little as a visitation fee.
Most people felt that pharmaceutical companies who made the opioid painkillers and sold them should be taking more responsibility; and a few blamed bad parents or bad communities. There was always a finger of blame pointing in a clear direction.
And then, inevitably, the question would be turned back on me. ‘Who do you think is responsible for the opioid epidemic?’ And as the months wore on, I found it almost impossible to answer that question. For the simple reason that everyone shares some responsibility for this epidemic.
Every day, we all in some way, big or small, push and pull at the overlapping boundaries of commerce, medicine, safety, parenting, policing, governing. And occasionally, we get it wrong.
We prioritise the wrong thing: be it safety and security, or the value of mitigating pain, or the need to have a profitable pharmaceutical industry.
Something went terribly wrong on Staten Island. It’s going wrong all around America. And it’s set to go terribly wrong in Australia.
I can’t say who’s responsible – because the list is too long, and many on that list have been victimised already. But I can say what we still seem to be doing wrong.
We don’t understand addiction very well. We don’t teach each other very well about what addiction means for the addict, or for their families. We don’t admit how easy it is to become addicted to opioids, or to any other pill.
We talk about ‘addictive personalities’ as the cause of addiction, a euphemism for someone who’s not emotionally or mentally strong enough to handle the medicine in question.
And yet – the strongest two women I have ever met in my life both struggled with getting off prescription painkillers. One of them lived on and is the best mother you’ll ever meet. One of them died of an overdose, and is much missed by her adult son.
Rather than placing blame, my personal opinion is that we first need to take stock.
Opioid addiction is the cruellest trap I’ve come across in more than ten years reporting for Dateline from across every continent. It can get anyone.
Opioid withdrawal seems to bring out the beast in the best of us: people will say and do things they never would have even contemplated before they became hooked on the drug. Many got hooked through legitimate supervised pain management; many started as early as twelve or thirteen years old.
I know many addicts. You do too.
Looked at a certain way, the mundane act of handing someone a prescription is asking them to make a solemn choice: take this highly addictive painkiller with all the risks of addiction and withdrawal that come with it; or live with the terrible pain that the pill is being prescribed to manage.
If we are going to ask anyone to make that choice, we need to explain it fully. We need to offer to supervise them more closely while they’re taking opioid painkillers, watching for concerning changes in behavior or personality.
We need to be entirely compassionate if they fall into the trap of addiction. And we need to offer more help to get out of it.
And most of all – we need to more fully admit the solemnity of the choice to medicate profound pain with highly addictive pills. All the while being on guard against the profit motive overtaking the compassionate desire to ease someone else’s pain.
I wish it were a more simple answer than that.
