Some takeaways: --We mustn't apply the same harm reduction strategies to both -- It is crucial not to misapply lessons learned from tobacco. Fundamentally, th

Some takeaways: --We mustn't apply the same harm reduction strategies to both -- It is crucial not to misapply lessons learned from tobacco. Fundamentally, this means accepting that—unlike cigarettes—opioids have genuine uses in both pain and addiction medicine. So far, however, we are doing the opposite. Rather than recognizing that some people with intractable pain benefit from opioids, we continue to reduce access— typically without offering affordable and effective alternatives. -- It is difficult to stop drug-seeking teens by leaving grandma in agony. -- Moreover, addictions typically start in youth, with 90 percent beginning as experimentation in adolescence or early adulthood. Chronic pain, in contrast, tends to arise in middle or late life. As a result, fewer than 8 percent of people who take opioids long term for pain develop new addictions, according to a review co-authored by the director of the National Institute on Drug Abuse. In fact, the age group prescribed opioids at the highest rate—those older than 65—has the lowest rate of addiction and overdose. (And no, this research was not funded by Big Pharma, even though they used some of it extremely dishonestly.)