Addiction Awareness Scholarship Campaign 2020 Round 2 – Addicts Are Usually Good People: Why We Must Destigmatize Opiate Addiction and Its Treatment Now


Addicts Are Usually Good People: Why We Must Destigmatize Opiate Addiction and Its Treatment Now

Addicts Are Usually Good People: Why We Must Destigmatize Opiate Addiction and Its Treatment Now

By Zach Bartell


For the Seasons in Malibu Addiction Scholarship


If I say the word ‘pain’ to most people I know, they will think of the sensation of stubbing their toe. My mom, a schoolteacher, will imagine a recent self-inflicted papercut she suffered at work, my dad, the tree branch that fell heavily on his head as he did weekend landscaping in their yard.

But there are other people I know who have experienced an entirely, categorically different type of pain.

Like my girlfriend, whose primary care physician for ten years failed to diagnose her rare condition of the skeleton and muscles that gradually developed into a source of chronic and often debilitating pain, and who I have watched pass many nights in sleepless agony as a result.

Like my girlfriend’s dad, who, after a catastrophic trucking accident, was trapped for hours with his arm stuck underneath his vehicle while the authorities struggled to free him, who then endured the amputation of his arm and continues honorably through his recovery.

These are pains that transcend all particular mediums of transmission, spreading like a disease from the physical to the emotional, to the psychological, into something complex, subtle, and all-consuming. Something that cannot be ignored by the person who feels it or the people who love them.

Across the United States, there were an estimated 50 million adults with chronic pain in 2016, of whom about 20 million, like my girlfriend and her dad, had high-impact chronic pain (Dahlhamer, et al., 2018). We cannot fully understand opiate addiction without reckoning with our nation’s healthcare system and its approach to pain control.

The usual cause that people attribute to the prevalence of opiate addiction in the US is the over-prescription of painkillers like Oxycontin and Hydrocodone, which began in response to national direct-to-provider marketing campaigns by major corporate drug manufacturers in the late 1990’s to early 2000’s (van Zee, 2009). In fact, the problem does have a direct connection to over-prescription, but its basis is far more multivariate than that.

Opiate painkillers exist because there is a serious legitimate need for an effective and reliable pharmaceutical solution to acute and chronic pain. And they have addicted millions of Americans because there are millions of us for whom nothing else is powerful or consistent enough to soften or eliminate our pain.

The truth is that for people like my girlfriend’s dad, recent amputees, victims of catastrophic accidents and injuries, it would be irresponsible for their providers not to prescribe prescription painkillers that are known to be extremely powerful. For still others, opiates can mean the difference between living a normal independent life, and seeing all their goals and dreams fall in tatters around them as their whole existence becomes an endless struggle with pain.

It is an established fact that many, perhaps most, people who take opiates over a prolonged period of time will inevitably become physically addicted to them. Until a nonaddictive, unproblematic psychoactive alternative is invented, this is a necessary fact that we must accept, for to do otherwise would be to condemn millions of our fellow Americans to a state of unbearable pain to which most would understandably prefer the peace of death.

The addictiveness of opiates is the proximal, not the ultimate, cause leading to the prevalence of addiction. Rather, the problem is that our medical system persists in unjust continuity-of-care practices that marginalize the addicted and perpetuate the stigmatization of effective treatment options.

It is not commonly understood that, even after being prescribed opiates for months or years by the same provider, even when that provider continues to increase the dose of the medication in a kind of arms race with the patient’s rising tolerance to it, there is no established medical practice outside of the drug rehab industry for helping addicted patients wean themselves off their prescription. At the end of a patient’s months-long recovery from a serious spinal surgery, for example, or an amputation, they may be left by their provider to deal, alone, with the state of taking dozens of pills of ultra-powerful opiate pills per day and suffering a life-threatening withdrawal process if they ever try to stop.

If the patient is lucky, they will be given a referral to a rehabilitation center that accepts their insurance. If unlucky, they will see their prescription terminated, no rehab center will be available or ‘in network,’ and they will have no other options but illicit black-market opiates to stave off the unspeakable agony of withdrawal.

That is America’s opiate addiction problem in a nutshell. Americans hurt, there exists an easy medicinal solution with remarkable addictiveness as a very serious complication, and our medical and insurance systems are incompetent to help patients skirt past the worst impacts of the complication. Millions of good, responsible people are left paying the price.

It is the medical-insurance-pharmaceutical system that bears the responsibility for the million tragedies of America’s opiate addiction problems. For the prevalence of untreated addiction to decrease, we as a nation must demand better treatment for our addicted brothers and sisters, husbands and wives, daughters and sons, and neighbors.

We must accept addictiveness as a necessary property of a flawed pharmaceutical typology that is, nevertheless, the best available option we have for pain control. But our efforts cannot end there; we must go further to demand that pain control treatment consider the whole person over their entire recovery process, which includes the period of time after the pain has subsided when the physical dependence on painkillers often replaces the original pain as the most important health factor to address.

Good, honest, and wonderful people like my girlfriend and her dad, unique individuals who have suffered more than most, deserve to have dignity in their treatment and recovery. If, by unhappy accident, they develop an addiction to opiates, the development is chemical, not moral, in nature. Like any mental or medical condition, pain can and must be treated. Addiction to a substance that causes marked release from pain is no different, and its treatment must be integrated into established medical practice and our everyday perceptions of a normal human’s experience.



Dahlhamer, J., et al. (2018). Prevalence of chronic pain and high-impact chronic pain among adults–United States, 2016. Centers for Disease Control and Prevention Weekly. DOI:

van Zee, A. (2009). The promotion and marketing of OxyContin: Commercial triumph, public health tragedy. American journal of public health, 99(2). DOI: