Continued Blaming of Purdue Pharma Won’t Solve the Opioid Crisis

By Lynn R. Webster, MD

On July 15, The Washington Post published an editorial urging states to use opioid settlement funds to expand naloxone access and addiction treatment programs.

These are sound public health goals. But the editorial’s framing — tying these investments to reparations for damage attributed to Purdue Pharma — rests on an oversimplified and misleading narrative that has shaped policy and public opinion for over a decade.

Purdue Pharma aggressively market OxyContin and contributed to early overprescribing. However, it was never the dominant supplier of prescription opioids. Analyses of pill counts, morphine milligram equivalents, and regional variation show that Purdue’s market share was often far less than one-third. While its actions were consequential, the disproportionate focus on Purdue distracts from the broader, ongoing drivers of the crisis.

Addiction is not caused by the availability of opioids alone, but also by the conditions that make people vulnerable: poverty, trauma, housing instability, and untreated mental illness. By fixating on corporate actors, we risk mistaking the spark for the fire — and neglecting the deeper issues that sustain the epidemic.

The editorial also perpetuates confusion between physical dependence and addiction. The former is a predictable response to long-term opioid use; the latter involves compulsive behavior and impairment. Blurring the two has led to harmful policies, including forced opioid tapers and abandonment of stable pain patients.

These policies have not reduced deaths. As prescription opioids became harder to obtain — often due to regulatory pressure — some patients turned to illicit alternatives; not to get high, but to avoid withdrawal or manage pain. This shift laid the groundwork for the explosion of heroin and illicit fentanyl use. Today, illicit synthetic opioids are involved in more than 70% of overdose deaths.

Framing settlement spending as payback reinforces a punitive narrative rather than advancing evidence-based solutions. Naloxone, youth prevention, and addiction treatment should be pursued because they work — not because they symbolize restitution.

The real challenge lies in addressing the conditions that lead to substance use in the first place. Reforming housing policy, expanding mental health care, and ensuring access to meaningful employment are more difficult— but are far more essential — than litigating against a defunct company.

We should also be asking why the healthcare system permitted aggressive opioid marketing, why insurers incentivized pill volume over outcomes, and why evidence-based addiction care and harm reduction remain chronically underfunded.

Managing the crisis requires more than blame. It requires accurate explanations, structural change, and sustained investment in public health — rather than narratives that feel satisfying but obscure the truth.

Lynn R. Webster, MD, is a pain and addiction medicine specialist, and serves as Executive Vice President of scientific affairs at Dr. Vince Clinical Research, where he consults with pharmaceutical companies.

Dr. Webster is the author of the forthcoming book, “Deconstructing Toxic Narratives – Data, Disparities, and a New Path Forward in the Opioid Crisis,” to be published by Springer Nature.