It’s reaching countries all over the world, but hitting hardest in the United States and Canada. This dangerous wave is the opioid addiction crisis, with an estimated 2.6 million Americans addicted to either prescription pain relievers or heroin, causing about 28,000 deaths every year. What once was considered primarily an inner- city problem no longer discriminates—it’s in the suburbs and small towns; it takes down the rich and the poor, the famous and the neglected; it preys on all races and all ages. To understand how the epidemic began, to comprehend the staggering numbers, to get a grip on the tactics for battling the crisis, it’s important to hear the voices of those who have found themselves in the midst of this devastating surge. Beyond the shocking death toll, the terrible measure of the opioid crisis includes the families ripped apart and, for many communities, a generation of lost potential and opportunity. This epidemic is a national health emergency, unlike many of us…[have] seen in our lifetimes.…We owe it to our children and our country to do everything in our power to address this national shame and this human tragedy. —President Donald Trump O piates are the synthetic version of opium-based drugs and have a psychoactive quality, meaning that they are designed to alter the brain in order to regulate perception, mood, or behavior. These include morphine, methadone, buprenorphine, hydrocodone, oxycodone, and heroin. On the streets, it might be known as “smack,” “China white,” or “chicle.” But what’s different about today’s war on drugs is that they have brand names: Vicodin, OxyContin, Codeine, Percocet, Tylox, and Demerol. Opioids are among the world’s oldest drugs, with documentation of opium predating the com- mon era, and morphine gaining use in the 1800s. Synthetic opioids rose in popularity in the 20th century as cheaper pain-killer alternatives, used commonly for acute pain following surgery and for cancer patients. Soon they became the solution for chronic pain, such as back and joint pain, chronic 8 WWW.AGRM.ORG JANUARY/FEBRUARY 2018