One thing the opioid crisis made visible was how precious of a resource social trust is. It did this in a negative way, by demonstrating very dramatically what happens when that trust is lost.
The crisis itself emerged from a confluence of destructive trends and developments. The regions hit the hardest tended to be regions suffering from economic neglect and/or a history of extraction and abandonment.
What's more, these regions were deliberately targeted by organizations like Purdue whose cultivated instincts were to seek out regions of economic opportunity to be exploited and exhausted for limited gain, instincts that have developed culturally and economically for centuries and more.
The economic opportunity in this case was a despair and a cultural malaise lingering as residue after earlier "economic opportunities" had run their course, which coupled with the more immediate necessities of pain relief, among other things, served as the perfect environment for dependency and addiction.
But the initial crisis, in which staggering numbers of patients became addicted and then accidentally overdosed, was only the beginning. The initial crisis itself primed the steady destruction of a powerful medical tool. Fear and alarm elevated the crisis to an epidemic-level event, and those hit the hardest by the convulsions of blame and reaction were the chronic pain sufferers themselves.
Now, just because a dodgy corporation produces something doesn't necessarily disqualify it as useless and/or destructive. But the nature of an organization does tend to be expressed in its products: products that don't work as advertised, and products that draw its customers in through extractive intent, reflect the intentions, activities, and care of its creators.
That said, the dominant form of production - and the dominant productive entities who owe their characters to the dynamics of that form - has thoroughly monopolized the field of medical procurement, and those in need of things like pain relief have to take what they can get. And opioids do work quite well for this sort of thing given average conditions.
But the crisis itself - along with a slew of other crises of varying natures but of common roots - has done profound violence to social trust. This leaves us with a medical establishment that doesn't trust its patients with powerful pain killers, and a greater society that doesn't trust the medical establishment to have their interests at heart, when those interests don't coincide with a healthy profit. This results in disruptions and dampenings in the distribution of opioids and the relief of those suffering from chronic pain who need them most.
And then you have the prized and upstanding members of high society like the Sackler family, who in comical-evil-capitalist-caricature fashion (like as in Milo from Catch 22 fashion) profit from both encouragement of the crisis and addressing the crisis with addiction treatments. This type of behavior, which must necessarily take place within the social body, induces mass paranoia in that body; it signals that with enough power, anything goes.
Further, no one can expect to be protected from such abuses, as the state will not go the distance to punish such offenders in any meaningful way. With mass paranoia at its peak, nothing can be done really without triggering some destructive impulse. If everyone already expects everyone else to behave in the worst way, then any sort of behavior that arises, whether benevolent or not, can only be interpreted as such.
It is one thing to lose trust; it is entirely another to have something like paranoia grow in its stead. And as we well know by now, woe to the society with a fully developed and self-reinforcing collective sense of paranoia.
