Summary and Analysis

The article highlights the vital role that policy decisions have played in creating and increasing the addiction problem. Actions that address only the latest crisis often end up making the problem worse as has been seen with many policy reactions to the addiction crisis.

Unfortunately, the lack of focus on policy continues: “Journalists continue to echo the three-wave story that places the blame overwhelmingly on pharma. But the second two phases didn’t just happen: they were driven by policy choices.”

We risk another similar mis-step if policy continues to focus narrowly and primarily on pharmacological “solutions” to the problem. Medication Assisted Treatment (MAT) drugs have a place, but MAT drug alone will not solve the personal, family or community problems. And widespread and unsupported prescription of MAT drugs is likely to have unintended consequences which could worse, not improve the situation.


Excerpted from Scientific American

Journalists have largely presented the overdose crisis as a story of three interconnected and perhaps inevitable waves. First, drug companies, led by Purdue Pharma, maker of the notorious OxyContin, convinced gullible doctors to prescribe unneeded opioids.

The second wave in this narrative begins around 2011, when states cracked down on “pain clinics” that were really pill mills, offering doses for dollars.

Finally, the third wave was initiated by dealers about four years later. Seeing a chance to make even more money, they began to cut heroin with illicitly manufactured fentanyl and various other synthetic opioids, which are both cheaper to make and more potent.