We live in a country where anything remotely related to the word opioid is just a statistic. A world in which we care more about our own well-being than that of others because they are just another person out of the many who are suffering from addiction.
It is their choice – not our problem.
That’s what we’re told, right? We are a product of our own choices, and as long as you don’t choose the “wrong” path, you won’t become another statistic. But how is it that so many people from all different walks of life make the same choice?
In reality, the opioid epidemic is about more than just our own decisions. It is more complex and far deeper ingrained in American society than we’re told. The truth is that this started at a time when the crisis could have been controlled. It should have been regulated and contained decades before it got to where we are today.
The opioid epidemic started in the late 1990s with the advertisement of prescription opioids by big pharmaceutical companies. In particular, Purdue Pharma, owned by the infamous Sackler family, was a producer of a powerful painkiller called OxyContin. Credited with the beginning of the opioid epidemic, Purdue Pharma and other corporations falsely claimed that their opioid products were not addictive and did not have any harmful side effects. Fueling their own capitalist self-interest, they increased supply and pushed their products onto doctors by lying about the “effectiveness” of their drugs, causing an increase in opioid prescriptions for pains that could’ve otherwise been treated effectively without drugs. For example, dentists in the U.S. are one of the most frequent prescribers of opioids to soothe temporary, acute pains, when there are also better alternatives like NSAIDs. Yet they, too, have fallen victim to the marketing of opioid companies, causing them to unnecessarily prescribe opioids to patients whose pains could’ve been treated in less harmful ways. With the influx of production and distribution came the inevitable wave of addiction, overdose, and deaths that increased starting in 1999 – a product of corporate greed and lies. Big pharma companies were making millions of dollars from people’s addictions.
From 2004 to 2017, numerous lawsuits arose both locally and nationally, claiming that drug companies like Purdue Pharma were aggressively and falsely advertising products. Within these cases, the plaintiffs and the defendants reached settlements worth millions of dollars, yet in many of them no fault was admitted by the defendant pharmaceutical companies, or the charges were unresolved. For example, in “West Virginia v. Purdue Pharma,” which was settled in 2004, the allegations against Purdue Pharma included aggressively pushing their product onto consumers and falsely advertising its addictive characteristics. While they ended up settling to pay $10 million over four years for drug abuse treatment, no fault was admitted. This illustrates how big pharma companies were so powerful that they could get away with issues that were severely affecting customers by paying a small portion of their enormous amount of profit. These suits exemplify a norm in U.S. capitalist society where silence is more coveted than justice.
Aside from companies who absorbed the blame for the opioid crisis, the Food and Drug Administration (FDA) also played a role in its formation. There were many regulatory inadequacies having to do with the FDA since it provided faulty oversight that led to the approval of addictive prescription opioids. For example, it failed to look into pharmaceutical companies’ claims that their drugs would be suitable for long-term use as opposed to short-term, and it did not require producers to prove the safety and effectiveness of their drugs, when it approved Purdue Pharma’s fake OxyContin labels. So while drug companies’ capitalist ideologies fueled the opioid crisis, the FDA failed to regulate their products when it was most necessary.
While the overuse of prescription opioids has overall declined over time, the addiction to painkillers never left U.S. society, with 54,045 opioid deaths accounted for just last year in 2025. Society still shies away from the topic of addiction and the people who are suffering, favoring our own self-reliance and interests. Meanwhile, the lingering effects of big pharma companies and their capitalist behaviors remain. We keep condemning those who have suffered from addiction, saying that they could have stopped before it was too late. But in doing so, we are ignoring the role that capitalism played in encouraging the overuse of opioids. The pipeline from big pharma companies, to doctors, to patients was a multi-step process, and its effects bled into society far beyond those who created it could ever imagine.
After the initial rise and fall of prescription drug addictions came two more waves of the opioid epidemic. We are currently in the midst of the opioid epidemic’s third wave, which began in 2013 and is the deadliest out of the three waves. At the time, there was a massive influx of illegally manufactured fentanyl and other synthetically made opioids infused in the U.S. drug supply. These drugs have been often disguised by drug cartels as prescription opioids, which has allowed for the significant increase in the supply of fentanyl. Exposure to these drugs has fueled the flames of opioid addiction even further due to highly addictive properties. This led to an aggressive increase in overdose deaths: they increased at a rapid rate by 890 percent, from 1 death per 100,000 people in 2013 to 9.9 per 100,000 in 2018.
In more positive news, however, opioid overdose deaths declined noticeably in 2024, from 79,358 in 2023 to 54,045 in 2024. Provisional CDC data predicts the declining trend continuing throughout 2025 as well. Some factors that have made this decline possible include more access to naloxone – an overdose-reversing drug – increased treatment, differences in how people use drugs, which kinds they use, and the effects of settlements involving opioid-related lawsuits. Naloxone has especially been pushed by the government and medical professionals as a significant tool to combat the opioid epidemic by temporarily reversing the respiratory depression overdose causes. While it was invented in 1961, it has become more accessible in the market and increasingly relevant in recent years because of the opioid epidemic’s prevalence. Yet the amount of opioid overdose deaths still remains severely high, as well as the general effects of fentanyl and other synthetic opioids.
So what has the federal government done about this? Overall, there have been various independently led initiatives to help combat the opioid epidemic. But in order to provide a viable solution to the problem, the federal government must also be involved. Congress passed three policy approaches to combat the crisis, which included lowering the supply of illegal opioids, decreasing the demand for such opioids, and reducing the harm from opioid use disorders. While opioid settlements have contributed to the available funds for drug abuse support, government agencies have found difficulties in executing solutions with long-term, stable impacts. Also, drug companies and their allies have a history of spending hundreds of millions of dollars on lobbying to hinder opioid policies that would affect their business. The most important point out of these three policies is to change the nature of opioid supply. The root of this crisis has always been the capitalist ideology that suppliers – from big pharma companies to drug cartels and other massive sellers – have embodied since the 1990s. These entities have profited from the addictions of others, ruthlessly racking in billions of dollars at the expense of people’s suffering. What should be a priority is enacting policies that limit the supply of drugs and an environment that supports the success of big pharma companies, such as regulatory laws aimed at suppliers. These types of laws can impose boundaries between people’s demand for opioids and the ability for any supply to reach them.
So while the opioid epidemic began during a time when the capitalist economy gave drug manufacturers agency to exploit others and sell their harmful, addictive products, the fight to end it is still not over. Many people do not have the luxury of choice in the way they have been exposed to opioids and suffered from addiction in American society. We have created such a stigma around drug use that it is easier to believe that people addicted to drugs are at fault rather than the systems built by capitalism. But we need to see beyond what has been embedded into our understanding of addiction because there are still opportunities to build from where we are now. In order to truly combat this crisis, both independent and government efforts need to focus on uprooting the supply and demand for opioids. What started this problem was capitalism creating opioid addiction in our society, but what can end it is a collective focus on weeding it out in the status quo and in the future.
Featured Image Source: Notre Dame News