Much journalism about the opioid epidemic focuses on people whose use started with a prescription. Alternatively, reporters downplay their subjects’ earlier drug misuse to emphasize the role of the medical system. The “relatable” story editors tend to seek—of a good girl or guy (usually, in this crisis, white) gone bad because pharma greed led to overprescribing—does not accurately characterize the most common story of opioid addiction, reports the Columbia Journalism Review. Most opioid patients never get addicted and most people who do get addicted didn’t start their opioid addiction with a doctor’s prescription. The result of this skewed public conversation around opioids has been policies focused relentlessly on cutting prescriptions, without regard for providing alternative treatment for either pain or addiction.
While some people become addicted after getting an opioid prescription for reasons such as a sports injury or wisdom teeth removal, 80 percent start by using drugs not prescribed to them, says the National Household Survey on Drug Use and Health. Most of those who misuse opioids have already gone far beyond experimentation with marijuana and alcohol when they begin: 70 percent have previously taken drugs such as cocaine or methamphetamine. A 2016 review in the New England Journal of Medicine co-authored by Dr. Nora Volkow of the National Institute on Drug Abuse, put the risk of new addiction at less than eight percent for people prescribed opioids for chronic pain. Since 90 percent of addictions begin in the teens or early 20s, the risk for the typical middle aged or older adult with chronic pain is lower. This does not absolve the pharmaceutical industry. The journalism review says reporters “need to become more familiar with who is most at risk of addiction and why—and to understand the utter disconnect between science and policy—if we are to accurately inform our audience.”