Trading One Crisis for Another Is No Answer to the Opioid Epidemic

This article, in a slightly edited form, first appeared in the Salt Lake Tribune on May 20, 2021.


Many years ago, I took on an unforgettable patient (“Jack”) who was on a high dose of physician-prescribed opioids. He wanted me to continue his high dosage.

But I was unsure whether the benefit of doing so outweighed the potential harm. I also worried that, if he died from a natural cause, his death would be attributed to the opioids and, ultimately, I would be blamed. Given that, and despite his objections, I tapered his medication.

Days later, I received a call from his daughter. She said he had chosen to end his unremitting pain with a gun. I live with question of whether he might have lived if I had continued to prescribe the medication he believed he needed.

As a pain specialist, I carry the burden of deciding how many opioids to prescribe, and for how long, and to whom. Opioids can kill. But so can under-treated pain. Opioid use and chronic pain are deeply intertwined. But today, one is being intensely scrutinized while the other is largely ignored.

After months of corresponding with the producer of HBO’s new documentary, Crime of the Century, I agreed to be interviewed. My interest in doing so was to share my professional knowledge about opioids and addiction, and also to give voice to the many people in pain I treated for years. I didn’t realize the documentary had a different agenda.

After viewing the documentary, some people may conclude I am an advocate for opioids. On the contrary: I strongly believe that opioids must be replaced as a first-line method of pain treatment. That said, it remains clear that a subset of the population does respond to certain opioids without incidence of abuse or addiction. People in this category typically have no other option. They are tortured by their daily pain, and they often see suicide as a means of escape. While the number of suicides in the U.S. continues to climb, studies show that people with chronic pain are at least twice as likely to report suicidal behaviors. Unfortunately, some of them successfully end their own lives.

It’s a shame that the documentary allowed America’s complex chronic pain crisis to be reduced to greed by opioid manufacturers. While the documentary rightly shows the aggressive, dishonest marketing practices of opioid manufacturers and the human toll that took over the last 20 years, the picture presented is woefully incomplete. This is my fundamental problem with the documentary.

We are facing a far more nuanced and complicated predicament than the documentary conveys. Its objective is to tell a riveting story, with heroes and villains. It doesn’t aim to include all the salient facts. What happens, for example, when politicians and regulators, ranging from well-intentioned to cynical, begin to practice medicine? What happens when they restrict access or, worse, ban entire classes of opioids from people who desperately need individualized treatment? Very simply, we swap out one crisis for another.

We’ve seen this story before. In the 1990s, “getting tough on crime” was the favorite sound bite of politicians, both Democrat and Republican, culminating with President Bill Clinton’s signing the 1994 crime bill into law. What resulted was the mass incarceration of a generation of primarily Black males. Now, a criminal justice reform movement has bipartisan support and aims to rewind the war on crime’s excesses. One crisis traded for another.

If people have a genuine change of mind about complex issues after careful evaluation, I don’t blame them. But we should hold decision makers accountable when they are seduced by a moral panic, and when they swing and miss at a deep-seated societal problem.

Years ago, my pain clinic was raided by the DEA which later declined to pursue a case against me. I was named in a host of anti-opioid lawsuits, from which I was released. Patients under the care of my team died not because of treatment, but despite it. I successfully treated thousands of patients, and have devoted my life to identifying safe and effective alternative pain therapies.

Jack’s suicide weighs heavily on my conscience, and most physicians undoubtedly have wrestled with similar, no-win dilemmas. If better policy solutions do not replace the status quo, Jack’s story may be well on its way to becoming the next crippling national crisis.


  1. Connie J Martin on May 23, 2021 at 12:22 am

    As always, Dr. Webster shines a brilliant light on what society considers the “opioid crisis” as the agenda pushed by the CDC going on for half a decade now. Have street sales gone down? No. Have opioid overdose deaths gone down? No. Have chronic pain patient suicides gone up? Yes. I had always believed that a couple of years illustrating that the CDC’s ‘guidelines – taken as mandates’ by many doctors, pharmacies, individual pharmacists, chronic pain specialists, and general practice doctors, would cause a revision at the least, or a total reversal in the CDC’s barbaric tactics heaped upon so many people in unrelenting pain -, but no, they have not. It seems that they are unwilling to admit that their intentions were good, but their solutions were not. I have not seen the documentary in question, but truthfully, I have avoided watching the many films produced, or endless magazine and newspaper articles over the last 5+ years on this subject, because the majority of these public presentations, always seem to take a stand that furthers the public’s misunderstanding, and misperception about the positive use of opioids for millions of chronic pain patients in the US alone. They don’t understand the difference between addiction and physical dependency, nor that a patient can have their chronic pain helped tremendously by the appropriate strength and dosing of opioid medications, without causing any harm. Until a little common sense and the actual resulting facts regarding the stringent guidelines that were put in place are now put forth for society to understand about this subject, the suicide rates for chronic pain patients will only continue to rise. The CDC should continue to concentrate on the COVID crisis, and finally get out of the lives of good, caring doctors and the treatment of their chronic pain patients. These two groups were NEVER the problem, to begin with.

  2. Kristine Anderson on May 23, 2021 at 12:48 am

    I am one of the people who was tapered off of opioids a few years ago. I went from managing a small house, a car and a dog to living in a long-term care facility because of it. So the change in meds hit me pretty hard. I can barely walk now and have so much pain I get nauseated and breathless. One big multi-bladed knife is turning and wrenching through my entire body where it is stuck, and never stops turning and churning. I don’t want opioids anymore, yet I am screaming for relief. Nothing works. Even my skin hurts. I’ve tried to kill myself more than once. “At first I didn’t succeed…” Last time I dialed 911 just in time. After much ado at the hospital, I live! I will NEVER try to do that again. Life is beautiful and precious. I’m so happy and thankful to be alive. Get help! Don’t do it!

  3. roxan lucan on May 23, 2021 at 1:24 am

    Just admitting one has pain tends to result in being classified as a ‘drug seeker’. As a canced pt, I thought I would be treated for pain. I was wrong. I have been told quite a few obvious lies. They insist I should take their terrible pills but offer no help. My oncology surgeon declared they no longer make Tylenol 3. Another oncologist insisted there was a law that pts could only have 3 days of post op meds. I asked the pharmacist, who actually laughed–of course it’s a lie. I know a lot of other cancer pts who complain of the same dismissive response. I know several discussing suicide. What is the solution? An army of desperate pts in wheelchairs demonstrating in DC? Move to another country?

    • NANCY ROBINSON on May 26, 2021 at 7:40 pm

      OMG Roxan, that is horrifying! As a cancer patient, they don’t want to give you pain meds? I can’t believe they are so dismissive of your pain, because they’re worried about being sued. I’m so sorry that you’re going thru this.

  4. Arnold Feldman on May 23, 2021 at 12:31 pm

    I practiced surgery and pain medicine for decades and never used opiates as first line drugs. But a small group of physicians took monies from Pharaceuticals companies and became influencers. The anti opiate crowd used this as a weapon and were successfully poised to rake in billions. I can con speak for others but I never took a penny

  5. Suzi on May 23, 2021 at 4:25 pm

    Important words that remind me how important a job storytelling is. And you’re right Lynn, it isn’t about staging heroes and villains, nor is it about getting that soundbite at the cost of accuracy. I appreciate your perspective, and see so much compassion and a lifetime of careful thought on this complicated issue. Just wanted to say thank you for your work and words.

  6. David Holzman on May 24, 2021 at 1:33 am

    The pain patients are the ones who should get the benefit of the doubt. These stories are heartbreaking.

  7. NANCY ROBINSON on May 26, 2021 at 7:50 pm

    “I live with question of whether he might have lived if I had continued to prescribe the medication he believed he needed”.

    This line infuriates me, for several reasons. First, that you did harm to that man, because you were worried about yourself. Instead of understanding and supporting him, you choose to reduce his pain medication, and I’ll assume you gave him nothing in place of it. You went along with the politics of it, instead of advocating for your patient, and now he is dead. I especially hate “the medication he believed he needed”, making it sound like he was malingering, or a drug seeker.

    I normally enjoy your posts, but I am extremely disappointed in your viewpoint on this. You failed your patient, and I’m glad that you live with the question of whether he might have lived if you had provided him the medications he needed. If there was no addictive indicators, or constant requests for increased dosages, and he had been stable on it for some time, there should have been no reason to do that to him. You had his records, and not only did you do NOTHING for him, you actually made him worse, by denying him lifesaving pain medication.

  8. Tye Kenneth Lawson on June 5, 2021 at 10:10 am

    I’m naturally frustrated because of disparities in Tx to individuals who can pay in cash
    I was in a horrible car accident and suffered a spinal compression Fx and was released with #30 5 mg hydrocodone/ APAP. .FOR A BROKEN BACK!.



  9. sharon on June 6, 2021 at 9:11 am

    Doctors are afraid of losing their big bucks lifestyle, so they follow the “rules”. The “rules” are made up by people who are not doctors or pain patients. The rule makers feel that too many people are taking pain meds but there so many more people in the world now and are living longer.

    I am afraid every month that my meds will be cut off completely or decreased to point where they are useless. It is not the way to live in constant fear.

    ‘ which didn’t exist till a few years ago. Couldn’t the doctors get together and fight the DEA,(in the patients best interest). Of course they COULD but they don’t . Too much trouble, fear of reprisal or not sure that DEA isn’t right.

  10. sharon on June 6, 2021 at 9:12 am

    Doctors are afraid of losing their big bucks lifestyle, so they follow the “rules”. The “rules” are made up by people who are not doctors or pain patients. The rule makers feel that too many people are taking pain meds but there so many more people in the world now and are living longer.

    I am afraid every month that my meds will be cut off completely or decreased to point where they are useless. It is not the way to live in constant fear.

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