Pain, Prescriptions, and the Crisis We Don’t Talk About

Every year, millions of Americans are prescribed opioids after injuries, surgeries, and medical procedures, medications intended to support their recovery and healing. What starts as a legitimate prescription meant to help someone walk again, return to work, or sleep through the night can spiral into opioid use disorder (OUD), a condition affecting over an estimated 6 million people in the United States today (CDC).

In 2023, more than 79,000 people died from opioid-involved overdoses, according to the CDC. Synthetic opioids like fentanyl now drive nearly 70% of opioid-related deaths (DEA), but the story rarely begins with illicit substances. Instead, it often begins in hospitals and clinics, where injury-related prescribing remains one of the most common entry points into opioid use. More than 8.6 million Americans misused prescription pain medications in 2023, many initially seeking relief from physical pain (CDC).

However, despite the scale of this crisis, treatment remains out of reach for most. In 2022, an estimated 9.37 million adults needed treatment for OUD, but only 25% received medications considered the gold standard for recovery (CDC MMWR). The rest faced barriers such as stigma, lack of access, cost, racial inequities, or the lack of recognition of treatment need.

These inequities are stark across communities. Research shows that Black and Latine patients are less likely to receive adequate pain treatment, but more likely to face criminalization rather than clinical support if dependency develops (JSTOR). Native American communities experience some of the highest overdose mortality rates, driven by systemic disinvestment and limited access to care (Drug Policy Alliance). The opioid crisis, like most other health crises, follows patterns of inequities long embedded in our health system.

The prevalence of prescriptions as an entry point for OUD reveals the importance of post-injury care. Every prescription decision, from dose and duration to education and follow-up, shapes whether pain management supports recovery or opens the door to addiction. Safer alternatives like physical therapy, non-opioid medications, and trauma-informed care may be used to prevent OUD (PubMed). Granted, many injuries and conditions require the pain relief opioids provide, and every patients prescribed an opioid should be educated on usage, tapering, safe disposal, signs of initial dependence, and in that case, where to get help.

Addiction is not a moral failure. It is a public-health issue rooted in pain, trauma, and systemic gaps. If we are serious about preventing OUD, we must change the way we handle pain, especially after injury, and build a healthcare system where treatment is accessible, stigma is dismantled, and no one slips through the cracks because they were just trying to heal.