"Her interviewees had easy access to opioids, yes, but they also felt betrayed by the world. When Silva presented her work recently, an economist told her, “Thi

"Her interviewees had easy access to opioids, yes, but they also felt betrayed by the world. When Silva presented her work recently, an economist told her, “This is, like, an everything problem.” "“I thought that was a really smart way of putting it,” she told me. Indeed, in one of their studies, the Princeton economists Anne Case and Angus Deaton, who coined the “deaths of despair” hypothesis, noted that opioid overdoses, suicides, and alcohol abuse are the results of “cumulative distress,” or the overall “failure of life to turn out as expected.” "The solutions to this “everything problem” are not clear. Silva told me that the opioid epidemic had made some of her interviewees even more resentful, because they saw their neighbors as too weak to pull themselves out of addiction. At times, they seemed to almost celebrate the pain of withdrawal from opioids, as a necessary way of toughening up. “They actually end up supporting programs that would give people less help or less aid, because they feel like it’s enabling to keep giving help to people who refuse to get better,” she told me. "One of Silva’s interviewees tried to convince her that stress is how people grow. But stress can also make people hurt.