A viewer of our show named David Miller sent me this message (somewhat condensed):
I just found your show on Netflix, and I loved it until I got to the episode on drugs. Specifically, the section on OxyContin. It really, really pissed me off. While I agree that we need to find better and safer alternatives, this drug has been heavily misrepresented.
In the real world, people with chronic pain problems (like me, and my parents) require it just to be able to function. I’m unable to work, cook, or even shower due to the extreme pain I’m in 24 hours a day. Without OxyContin I’m plagued by chronic fatigue because it takes so much energy just to be alive.
Taken appropriately, it’s basically impossible to become addicted.
Lawmakers would have us believe that prescription opiates are a gateway to abuse and heroin. The reality is that heroin addicts only seek (or buy) prescription opiates when they’re unable to get heroin. Why would they? Heroin is fifty times stronger than OxyContin and actually SIGNIFICANTLY cheaper than it too.
I’d like to thank David for his message. When we did our 2016 segment on how pharmaceutical companies created the opioid crisis, the narrative that unscrupulous doctors who got patients hooked on their drugs was widely reported. In the time since, it’s become clear that this narrative was not entirely correct.
While Big Pharma is absolutely culpable for causing the crisis, the blame put on doctors and patients has resulted in many people with chronic pain being unable to fill their prescriptions because of the unfair presumption that they might abuse them. A particularly good piece of journalism on this topic is The Pain Refugees, by Brian Goldstone in Harper’s; it is a harrowing account of patients who suddenly lose access to the only treatment that works for them. That is wrong, and unfair.
While I don’t think the evidence bears out David’s assertion that there is no connection between prescription opioids and addiction, I do wish that our segment had focused less on the behavior of individual doctors and patients, and kept the spotlight on the corporations that are truly to blame. Were we to do this topic again, knowing what we do today, we would have approached it a bit differently.