This article, in a slightly edited form, first appeared on Pain News Network on February 19, 2021.

Rush Limbaugh was as controversial as he was politically influential. In fact, Nicole Hemmer, an associate research scholar at Columbia University, called Limbaugh “the man who created Donald Trump” and opined that Limbaugh created the foundation that catapulted Trump to power. In fact, Trump awarded Limbaugh the Medal of Freedom, our highest civilian honor, for his “decades of tireless devotion to our country.”

But the Independent website points out that, despite the influence he held over his millions of listeners, Limbaugh left behind a legacy of “divisiveness, cruelty, racism, homophobia, bigotry, and sexism.” Limbaugh was a “radio host who trafficked in bigotry and cruelty,” as Rolling Stone said. It’s hard to argue with either of those statements. He was, indeed, a deeply flawed human being who caused harm.

A Troubling Statement About Addiction

And yet Mark Frauenfelder, Editor-in-Chief of The Magnet, tweeted: “Rush Limbaugh, the sex tourist and drug addict whose four marriages, mockery of people after their deaths, and overt racism and misogyny made him a beloved icon of American conservatism, is dead at 70.”

That statement is troubling. Overt racism and misogyny are character flaws. Drug addiction, however, is not. It’s unfortunate to see Limbaugh’s detractors point to his well-documented problems with painkillers as moral failings. This supports my firm belief that our culture holds deeply negative views of people with addiction.

History of Back Pain and Drug Use

Apparently, Limbaugh began to use prescription painkillers after his spinal surgery in the 1990s. He was eventually arrested on drug charges—specifically, charges of fraud to conceal information to obtain prescriptions, or “doctor shopping.” He posted $3,000 bail and was released. In exchange for having the charges against him dropped, Limbaugh agreed to undergo drug treatment and pay $30,000 in court costs.

I wrote about Limbaugh’s prescription drug problem in my book, Avoiding Opioid Abuse While Managing Pain. What we knew about Limbaugh’s problem, as I said at the time, was that he abused large quantities of prescription opioids for several years; kept his abuse secret from family, friends, and colleagues; entered a rehabilitation program twice, but relapsed each time; remained successful without a visible reduction in functioning while he used drugs; and was suspected of buying drugs illegally.

What we didn’t know, and perhaps now can never ascertain, is whether he had an addiction or an undiagnosed psychiatric disorder (although some may argue his professional conduct was evidence of a disturbed personality).

We also can’t know whether his main motivation for seeking out drugs was to control physical pain, to mask emotional pain or stress, to seek a “high,” or some combination of those reasons.

The answers to these questions—about his history of drug abuse, mental health, and motivation—would have told us whether his opioid use disorder (OUD) was treatable with better pain control or, tragically, was an incurable disease. Limbaugh exemplifies the type of patient most physicians face when treating serious pain conditions. Sometimes, opioids fail to provide adequate relief for them. And, sometimes, these patients cannot access the opioids they need due to misguided polices and regulations.

How Society Views People With Addiction

Some people may agree with Limbaugh’s political and social views, and others may not. But conflating his drug abuse and associated illegal activities with the opinions he expressed about social issues harms people who suffer from the disease of addiction. It also makes it more difficult for people with severe pain to receive the care they deserve whether their abuse is caused by addiction or, as is often the case, it is a symptom of undertreated pain.

Many of those with addiction may not have the power or influence to bail themselves out of prison or pay tens of thousands of dollars in court costs. They may remain in prison for years, and during that time, they may suffer the loss of their careers, reputations, homes, and even their families.

Generally, our society views people with addiction as flawed, weak, and hopeless. We distance ourselves from those who have the disease, and we allow the criminal justice system to have jurisdiction over them at the same time as we make it difficult, or even impossible, for them to receive treatment.

We may never know why Rush Limbaugh made the choices he did. But, just as we would never think of berating him for falling victim to the lung cancer that took his life, we also shouldn’t chastise him for misusing painkillers. We may have a right to judge Limbaugh’s behavior, but we cannot, in decency, judge his disease.

 

Lynn R. Webster, MD, is a vice president of scientific affairs for PRA Health Sciences and consults with the pharmaceutical industry. He is author of the award-winning book, “The Painful Truth,” and co-producer of the documentary, “It Hurts Until You Die.” Opinions expressed here are those of the author alone and do not reflect the views or policy of PRA Health Sciences.

You can find him on Twitter: @LynnRWebsterMD.