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Two years ago I answered an early-morning phone call. “He’s dead … he’s dead …,” my daughter kept repeating. “Oh, my God … no …”

A friend who’d been sleeping on her couch lay face down on the living room floor. He’d overdosed on prescribed opioids. My wife and I stayed on the phone as emergency responders arrived. Medical professionals gathered around the young man. The police questioned my daughter. They searched her apartment.

They found no illicit drugs — just a devastated young woman comforting her toddlers.


This tragedy was one early pebble in the avalanche of opioid addiction now crashing into communities across our nation. In 2016, more than 55,000 Americans died from drug overdoses. The trauma is immeasurable.

Addiction is a disease, a medical illness, labeled officially as a “substance use disorder.” Yet too many of us still believe addiction to be self-inflicted — that people choose this life of shame, guilt, helplessness, and hopelessness. And those suffering from substance use disorders often internalize that belief.


I understand the dynamic. Before I entered treatment in 1989, I, too, used alcohol and other drugs. At the age of 26, I felt guilt and shame for having ended up in a psychiatric hospital.

I believed it was all my fault.

Powerful external forces reinforce this message. Pharmaceutical executives deny responsibility for the opioid epidemic, even as companies like Mallinckrodt Pharmaceuticals, which makes the highly addictive oxycodone, pay multimillion dollar settlements. Their language is careful but revealing. They use terms like “misuse” and “abuse.” They argue that their products are “designed to heal, not harm.” They rarely concede that these products are inherently addictive.

The Centers for Disease Control and Prevention paints a very different picture. A recent report by Anuj Shah, Corey J. Hayes, and Bradley C. Martin finds that, for those starting a course of opioid therapy, the transition from initial pain treatment to chronic, long-term continued use begins within days. Among individuals prescribed opioids for eight days or more, 13 percent were still taking them a year later. Among those given a monthlong prescription, that number rose to 30 percent.

Neither corporate deflection nor uninformed assumptions about “personal responsibility” will solve this crisis. Indeed, such messages are profoundly unhelpful.

Opioid use is dangerous and substance use disorder is very difficult to successfully treat. But effective treatments do exist, just as they exist for other medical illnesses. Suffering individuals and their families must not be shamed into silence. They must feel free to speak up and get the help they need.

With the aid of medical and addiction professionals, I began to recover. I earned a bachelor’s degree and then a master’s in social work. I spent 15 years on the front lines, providing clinical, addiction-related services. Later, I completed a doctorate and now teach and research these issues as a professor at Washington University in St. Louis.

My daughter’s friend was not so fortunate. Raised in Shepherdsville, Ky., he was an honor roll student at St. Xavier High School. But shortly after graduation, he was involved in a car wreck. He was prescribed opioids, became addicted to them, and soon began using heroin as well. For five years he wrestled with the illness, until the night emergency medical technicians carried his body from my daughter’s living room.

He was 24 years old.

David A. Patterson Silver Wolf, PhD, is associate professor in the George Warren Brown School of Social Work at Washington University in St. Louis. He chairs the American Indian and Alaska Native concentrations in the Master of Social Work program.

  • Yes, it’s true. Shame should not be a factor in problematic substance use. But this article is sorely misleading at best. There is a difference between physical dependence and addiction, and the problem is far bigger than getting a prescription for opiates and ending up using heroin. A lot of missed opportunities fir the TRUTH in this purely sensationalized article. It scares me that he has such a position- same “reefer madness” as any politician. Sad

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