Last April the photographer Nan Goldin staged an anti-opioid protest at the Smithsonian Institution's Arthur M. Sackler Gallery, which she targeted because of its namesake's connection to Purdue Pharma, the company that makes OxyContin. Yet Arthur Sackler, a psychiatrist and pioneer in medical advertising, died in 1987, at which point his interest in the company that would become Purdue Pharma was sold to his brothers, Raymond and Mortimer. That was eight years before OxyContin was introduced, and Arthur's heirs never saw a dime of profits from sales of the drug. According to Thessaly La Force, who profiles Goldin in The New York Times today, the artist is unfazed by these facts: "She says that Arthur Sackler, who ran an advertising agency that successfully marketed the drug Valium in the '60s, essentially created the model that was later used by his brothers…to sell OxyContin for profit, ultimately at the expense of lives."
Journalists who cover Goldin's activism, which she attributes to an OxyContin prescription that went horribly wrong, show a similar slipperiness, gliding over the biographical details that complicate the misleading and pernicious narrative of an "opioid epidemic" driven by the accidental addiction of drug-naive patients treated for pain. La Force, unlike her Times colleague Colin Moynihan, at least acknowledges Goldin's long history of substance abuse, which includes intermittent addiction to heroin beginning in the early 1970s, more than two decades before OxyContin existed. La Force also notes that Goldin was well aware of OxyContin's reputation in 2014, when she received a prescription for it to treat wrist pain while living in Germany. "I had heard it was a really evil drug, but I didn't think it would do me," Goldin tells La Place. "I thought I had a lot of control."
It is hard to see why, given Goldin's earlier experience with addiction to pain pills. In 2014, the same year she received that OxyContin prescription, Goldin told The Guardian's Sean O'Hagan she had experienced "a few relapses" since entering rehab in 1988, "including a 'major' one in 2000, when she was prescribed strong painkillers for a serious injury to her hand." La Place does not mention that episode, which shows that Goldin knew she had trouble controlling her use of pain medication long before the OxyContin prescription that she says propelled her down a path that led to a nearly fatal fentanyl overdose and into a new career as an anti-opioid activist.
Goldin herself does not mention her decades of polydrug use in her Artforum and Time essays explaining the roots of her activism. Given the way she describes her OxyContin-triggered addiction and ensuing brush with death, most readers undoubtedly will assume she fits the profile that the government presents as typical: A patient unwittingly takes a "highly addictive" drug prescribed for pain and is hooked before she knows it. "I didn't know they'd be this addictive," say the addicts portrayed in the federal government's new anti-opioid ads, who deliberately injure themselves so they can get prescriptions for pain pills. "I didn't know how far I'd go to get more."
But the truth is that prescription opioids are not "this addictive" for most people, as this exchange between Goldin and La Place illustrates:
Goldin asked if I ever tried an opioid. I told her that in college, I took OxyContin once; it made me feel sick. She nodded. I asked her what opioids felt like for her. "They make everything all right. They're like a padding between you and the world," she said. "It's this round warmth that's covering you." She looked away. "Everything is bearable suddenly."
Goldin had a background of psychological trauma, emotional sensitivity, and addiction that predisposed her to abuse pain medication. But even patients with risk factors usually can take pain medication as directed without becoming addicted. As Nora Volkow, director of the National Institute on Drug Abuse, and A. Thomas McLellan, a former deputy director of the Office of National Drug Control Policy, noted in a 2016 New England Journal of Medicine article, "Addiction occurs in only a small percentage of persons who are exposed to opioids—even among those with preexisting vulnerabilities."
It is accurate to present Goldin's experience as representative of opioid addiction in the sense that her drug use involved multiple substances, predated her abuse of pain medication, and was driven by psychological problems that made life inside a warm cocoon appealing. But omitting those details reinforces the myth that the average patient who takes opioids for pain faces a high risk of addiction, which makes it harder for people to get the medicine they need to make their own lives bearable.