The True Cause of the Opioid Epidemic
New research supports the idea that economic distress led to an increase in opioid abuse. But some say the origins of the epidemic are far more complicated.
The triplicate paper, in essence, makes it look like the opioid epidemic was mostly the fault of Big Pharma’s marketing, not the result of an economic shock. But David Powell, a senior economist at Rand and an author of the triplicate paper, thinks both could be true. To get the worst drug overdose epidemic in U.S. history, he says, “you need a huge rise in opioid access, in a way that misuse is easy, but you also need demand to misuse the product.”
The next step will be for researchers to see how the marketing of opioids interacted with economic conditions to increase the likelihood that a given place would succumb to addiction. In the meantime, researchers working on the ground say opioid addiction looks like the result of a perfect storm of poverty, trauma, availability, and pain.
When Silva, the Bucknell sociologist, asked her subjects about their painkiller addictions, they would often link their problems back to the decline of coal. When the coal jobs went away, they said, families fell apart. Some people started drinking heavily and abusing their children—who then went on to be traumatized themselves and sought the relief of OxyContin. Some grew bored and aimless without a job, and they started abusing drugs to fill the time or to ease their sense of purposelessness. Some had to switch to other manual jobs, and days of heavy lifting eventually took their painful toll. OxyContin was just a short doctor’s visit away—in one case, a doctor would simply refill opioid prescriptions by phone. “The men and women in this book suffer from physical pain—muscles torn and backs worn out by heavy lifting and repetitive tasks,” Silva writes. But they also “turn to food and Percocet, heroin and cigarettes, to manage the feelings of anxiety, disappointment, and trauma from their pasts.”
Her interviewees had easy access to opioids, yes, but they also felt betrayed by the world. When Silva presented her work recently, an economist told her, “This is, like, an everything problem.”
“I thought that was a really smart way of putting it,” she told me. Indeed, in one of their studies, the Princeton economists Anne Case and Angus Deaton, who coined the “deaths of despair” hypothesis, noted that opioid overdoses, suicides, and alcohol abuse are the results of “cumulative distress,” or the overall “failure of life to turn out as expected.”
The solutions to this “everything problem” are not clear.
‘Not clear’? Maybe they are clearer than people want to admit?
When you excise not only purpose, but sustainable meaning from the human context, psychological break-down begins. One can attempt to assuage it with distraction and consumption, but it is vacuous cavern that isn’t filled by such sociological pop-culture trinkets or maneuvers.
One must go ‘beyond’ the superficial facades to find real solutions to the ‘everything problem’, but will we really look?