How the Opioid Epidemic Became a Uniquely American Problem

In recent years, the opioid crisis and the toll it has taken on American families has dominated headlines. Now that nearly 400,000 American lives have been lost, there’s been much debate over who the true culprits behind the epidemic are, from Big Pharma to doctors to billlionaire families like the Sacklers, which are now facing more than 1,000 lawsuits accusing them of deliberately downplaying the risks of prescription opioids in order to continue reaping profits.

But as Rund Abdelfatah and Ramtin Arablouei, the hosts of the NPR podcast Throughline, recently found while researching their episode on the history of opioids in the United States, the roots of the crisis go back much further than one would suspect. The story of the opioid crisis, Adelfatah says, is essentially a story of pain, and how Americans have historically treated it: “There was a recurring question of whose pain is taken as ‘real pain’ and how do we address it?,” she told Rolling Stone. “There was definitely a gender bias in the 19th Century around treating pain; there was a racial bias, and a lot of these biases remain in different forms today.”