My AEI colleague Sally Satel adds some nuance to the conversation on opioids in a fascinating essay at The Atlantic.

Now that the fever of the opioid crisis may be breaking, Americans can revisit some of the stories we have told ourselves about the role of prescription medication in the crisis. Did policy makers and public-health experts correctly assess who was at risk of becoming addicted to opioid medications? Were their views on the addictive potential of such drugs realistic? Did they anticipate the consequences of policies devised to constrain doctors from overprescribing? In retrospect, policy makers seriously misjudged the answers to these questions, overestimating the risk that these drugs posed to the average patient while simultaneously doing too little to urge clinicians to identify those most vulnerable to addiction. The best time to correct course is now—while the opioid problem still commands public attention, and before the restrictions imposed at the height of the crisis harden into permanent practice.

[Emphasis added.]

Dr. Satel challenges the prevailing understanding of who becomes addicted to opioids, and how.

From 1999 to 2011, the CDC documented a fourfold rise in prescription-related overdose fatalities. In 2011, the agency officially declared “prescription painkiller overdoses at epidemic levels.” On charts, the data were straightforward—casualties mounted in parallel with the rise in opioid prescribing—but the dynamics behind the trend were not. What became the popular but essentially dubious interpretation of the trends was that the typical opioid victim was a patient who received Oxycontin, Percocet, or Vicodin from her doctor for a tooth extraction or sprained ankle and then stumbled into addiction.

Satel is not only a nationally recognized expert in health policy. She has seen this crisis up close. She writes:

I am a psychiatrist who, for the past 11 months, has taken a break from urban life to do some clinical work at a behavioral-health clinic in a small community in southeastern Ohio. I have gotten into the habit, as I go around town, of chatting with anyone who seems friendly.

Check out her entire essay here.