We've recently heard that President Donald Trump allegedly used the word "shithole" to draw a dividing line between us and them. He seems to feel safer standing on his side of that dividing line as long as he keeps others standing on the other side, where he believes they belong.

I have to wonder if our country’s drug policy is weighted with some of the same social divides, and whether that helps explain why policymakers have ignored the needs of people in pain and with addiction who are them, not us.

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24-year-old

to "help lead" the Office of National Drug Control Policy (ONDCP)?

Unfortunately, the Trump administration seems to be leaning in the direction of slashing the ONDCP's budget by 96 percent rather than providing support to the socio-economically depressed areas of the country that are the seeds of perceived holes.

Also, could this explain why the president declared the opioid crisis to be a national health emergency but provided no funding?

Perhaps he deems people with opioid dependence or addiction to be unworthy of treatment, or he considers them to be too far down the hole to merit help. His actions seem to lend credence to the theory.

Maybe the Trump policy is to ignore those on the other side of the line. If so, I can empathize with those in need who might be targeted by that choice.

Some people perceived the farm where I grew up as a hole. I knew, because they had the ill manners to say so at the time.

My siblings and I attended a one-room country school with an outhouse instead of indoor plumbing. By some standards, we were living and learning in a hole, but we never thought of it that way. We had a surfeit of love, self-respect, humor, hope, and pride.

As a farm family, we knew how others viewed us. We were uncouth hicks. We heard it so often that we sometimes even thought of ourselves that way.

John Kenneth Galbraith, who was a scholar and one of the most famous economists of the 20th century, wrote a book called "Anatomy of Power." It begins with a preface that describes the inferiority complex many farmers experienced in the early- to mid-20th century.

He was correct in observing that many farmers had an inferiority complex. But it was not clear to me why farmers felt that way. It once seemed to me that the reasons had to be superficial. Perhaps it was because most farmers wore overalls, had dirty hands, handled manure daily, and used poor grammar.

But I now understand that the reasons ran deeper than that. Farmers instinctively knew about the dividing line between us and them, and we understood that — to outsiders — we were them.

However, from our vantage point, farmers like us lived, studied, and worked in our community. It wasn't a filthy hole, nor was it a drug-infested den. It was home.

We had social problems just as our city-slicker fellow Americans did. My community members had some bad habits that were indigenous to the culture of the time, but so did our counterparts who lived elsewhere.

We struggled to make our lives better, culturally and economically. Some of us were able to move beyond the hole. Achieving upward mobility might even have been easier for me than it was for some who lived in the city because I was white, male, and part of the Judeo-Christian majority.

Must living in difficult circumstances lead to substance abuse? Of course not. People can make life-affirming choices from the grittiest addresses.

People who live on the other side of the tracks, in affluent communities, sometimes succumb to pain, temptation, disappointments, and so on by abusing drugs, too.

The drug epidemic is a crisis for people on every part of the socio-economic scale. Yet people with resources rarely tend to be marginalized as readily as those whose poverty makes them invisible and denies them a voice. Those who are castigated because of their environment will struggle more than they would have to if there were helping hands, rather than judgmental words, extended to them.

Change is hard, and it will be unlikely to occur until we erase the dividing line between us and them — and create a unified we.

Lynn R. Webster, MD is the vice president of scientific affairs for PRA Health Sciences. He is a former president of the American Academy of Pain Medicine. Webster is the author of “The Painful Truth: What Chronic Pain Is Really Like and Why It Matters to Each of Us.” You can find him on Twitter: @LynnRWebsterMD.