Recognizing, Reconnecting, Doing Something: A Prescription for America's Pain

In this week's New York Times, David Brooks offers a hopeful vision of what we can do with America's pain -- not just the literal chronic pain (afflicting 50 million Americans, 1 in 5 adults), but the pain caused by the opioid crisis and all of America's other social problems. Parents losing teenagers to overdoses. People feeling isolated, caught up in their own perceived worthlessness. Brooks identifies a "common thread" that I address in Chapter 6 of The United States of Opioids, the "Deeper Roots" of the opioid crisis.

My original vision in writing the book was my sense that the conversation around the opioid crisis was like ships passing in the night: the public health policy community focusing on containing a spiraling overdose death rate was not having meaningful dialogue with the addiction treatment community. The community treating and suffering from chronic pain were left out of the conversation altogether. Despite the fact that this crisis is a series of interwoven problems that need attention in a unified conversation, our discourse has not been addressing the issues comprehensively. I felt uniquely positioned to tie up many loose ends and misperceptions by virtue of working across numerous segments of the healthcare world and participating in both high level discussions and on-the-ground work.

One of my biggest frustrations has been the oversimplification of the issues. We villainize Big Pharma for their central role in the opioid crisis, but we ignore many other broader points of health system failure -- and the way that Pharma continues to be a bad actor. (Earlier this month, the Academy for Integrative Pain Management announced that it was shutting down, its funding suffocated because it was making the case for ways to treat pain other than pharmacology. We continue to have perhaps the most powerful lobby in America hobbling our efforts to improve care.)

But in writing the book, I got to the same point that Brooks alludes to in his article, the overwhelming sense that, when you look at the 40 year crisis of exponentially rising overdose death rates across all drugs, the issue is not any particular drug but the social crisis running through American life: deep anxiety about the future, a lost sense of purpose, despair, a sense of isolation, and chronic stress. Brooks gets to a similar point via different route. He diagnoses the "common thread" of America's deeper pain as "our lack of healthy connection to each other, our inability to see the full dignity of each other, and the resulting culture of fear, distrust, tribalism, shaming and strife." Amen.

I believe that, if we don’t begin to address these challenges, then all of the healthcare reform in the world amounts to “rearranging deck chairs on the Titanic.” So what can we actually do? In Chapter 10 of The United States of Opioids, I make the case that we need to start a new conversation about not just fixing healthcare, but changing ourselves: how we parent, how we engage in supporting wellness in the workplace, what we teach in our schools, what we do in our religious communities, and, above all, how we interrelate in our broader communal spaces -- getting rid of the shame in order to get people to talk about the pain. Expressing concern without judgment to get people the help they need.

In his article, Brooks likens the overdose crisis to Pearl Harbor and asks "Aren't we called at moments like these to do something extra?" Amen, David! In sharing the message of my book, I keep meeting people coming at the problem with different perspectives and different prescriptions than my own -- people who are doing something. I met with Media Policy Center founder Harry Wiland, one of the filmmakers behind "Do No Harm-The Opioid Epidemic." Wiland and his co-founder of MPC, Dale Bell, are filmmakers and journalists who are focusing, among other things, on creating accessible video educational content that kids and schools can access and use for prevention. Their work, in turn, highlights other people making a difference.

Brooks shares his own involvement in the Aspen Institute's Weave: The Social Fabric Project, which is trying to understand the issue of America's social isolation by looking at problem-solvers around the country who are "building community and weaving the social fabric." He talks about a bunch of inspiring examples: a vet helping other vets dealing with mental illness in New Orleans, a boxing gym owner in Ohio teaching young men about life through boxing, a woman in Florida who spends her week looking out for local kids and visiting people in the hospital.

For me, the irony about what Brooks describes and that runs through The United States of Opioids is that, in a time when there is much to discourage us, to make us think we are facing insoluble problems and an existential crisis, there is also much to be hopeful about. There isn't one solution to the opioid crisis and the interrelated problems we face: there are 330 million potential solutions, each waiting for one more person to commit themselves to some action to make a difference. If you're already on the same page, I'd love to hear about what you're doing. If you are wondering how to get involved, I'm glad to share ideas as well. Ultimately, the prescription for liberating a nation in pain is all of us doing something.

Harry Nelson is the author of The United States of Opioids: A Prescription for Liberating a Nation in Pain (Forbes 2019). To learn about how you can contribute to Harry's projects to tackle the opioid crisis, visit https://notanotherstat.com and https://bhap.us/force/.