Bob Schwartz

There is bipartisan agreement that we have a national problem of opiodd and heroin addiction. But few politicos are willing to discuss the hard questions.

The political consensus is that we address the addicts and how to treat and end their addiction. Which is a good and humane objective.

But there are two other aspects the politicos are less willing to take on.

Supply chain

The old school war on drugs went for the top of the supply pyramid. Think El Chapo. In the case of opioids, that supply chain leads up from pharmacies to doctors to pharmaceutical companies. But if you listen to the grandstanding from Democrats and Republicans, you hardly if ever hear the legal producers of the drugs called to account. It is true that product makers are not unconditionally responsible for how people ultimately use their products—not alcohol makers, not cigarette makers, not gun makers. But at least those suppliers can be spotlighted as significant stakeholders.

Where does it hurt?

Pain killers are a blessing to those who suffer from chronic physical pain or from intermittent severe physical pain. That kind of pain is a damnable thing, and we should all be glad that we have developed such a solution.

Millions of those who use painkillers, prescription and otherwise, are not in physical pain. But many of them are in psychic pain, whether out of loss, desperation, frustration, purposelessness, difficult circumstances, or just boredom. It is convenient but not completely helpful to lump these into “mental Illness” for which increased funding and access could be made available. This kind of pain is not illness; it is just a response to a condition or injury, no different than the hurt that might come from being hit over the head really hard.

Politicos don’t want to talk about this. The solutions to this kind of pain involve changes in society and in people’s lives that require lots of self-awareness, lots of politically tricky analysis, lots of controversial proposals that go beyond better addiction services. And lots of hard questions that politicos don’t want to ask, let alone try to answer. Such as:

Where does it hurt?