Five sentences. Longer than a tweet but shorter than the average elementary school essay. That’s the length of an influential letter published in 1980 in the New England Journal of Medicine, the world’s most prestigious medical journal. It alleged that narcotics are not addictive. This letter, combined with aggressive marketing efforts by pharmaceutical companies and the emergence of improving pain control as a focus for physicians and hospitals, led doctors to begin prescribing opioids as painkillers for conditions that once simply called for aspirin.

The outcome of this perfect storm? Millions of Americans addicted to opioids, and more than 200,000 dead by overdose between 1999 and 2016. And that number keeps growing.

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