The Opioid Tragedy, Part 1: ‘We’ve Addicted an Entire Generation’

How pharma greed, government subsidies, and a push to make pain the “fifth vital sign” kicked off a crisis that costs $80 billion a year and has killed hundreds of thousands of Americans

Oxycodone pain pills prescribed for a patient with chronic pain. Photo: John Moore/Getty Images

The U.S. is in the throes of a full-blown crisis of opioid overuse, abuse, damage, and death. As far back as 2006, federal health institutes flagged what they called “disturbing data about a spike in opioid addictions. But the message didn’t seem to get through. Prescriptions for opioids continued to rise, and during the Obama administration, opioid abuse was declared an epidemic. The crisis has persisted under the Trump administration.

The good news is that overdose deaths have finally stopped increasing, for the first time since 1990. Still, tens of thousands of people each year are dying from opioids — especially the street drugs heroin and synthetic fentanyl but also prescription painkillers like Oxycontin, Percocet, and Vicodin. Aside from the loss of life and the broken families, consider the economic cost of prescription-opioid abuse. The Centers for Disease Control and Prevention recently put that number at nearly $80 billion a year, once you add up the costs of health care, addiction treatment, lost productivity, and policing and imprisonment.

How did we get here? And what does the complicated dance between supply and demand have to do with the opioid crisis?

When it comes to opioid addiction, Dr. Jeanmarie Perrone of the University of Pennsylvania is one of the most active researchers and practitioners around. Perrone runs a medical toxicology and addiction department in the University of Pennsylvania’s medical system, which means she’s an ER doctor as well as a professor and researcher.

The University of Pennsylvania medical center is in Philadelphia, which has a particularly high rate of opioid abuse. In one recent year, for instance, twice as many people died in Philadelphia from drug overdose — most involving opioids — as from homicide. The city’s health department estimates that some 75,000 Philadelphians are addicted to heroin or other opioids: That’s nearly 5% of the population. Perrone has…