Across the United States at least forty people die each day from overdosing on opioids like Vicodin, codeine, heroin, and oxycontin. Seven percent of drivers who died in car crashes last year were found to have prescription opioids in their systems — seven times more than in 1995.

Considering these alarming rates of overdosing and DUIs, this is serious business. Authorities view it in their traditional way: the problem is drugs. Thus doctors should curtail prescribing, and patients should clean up and go through rehab.

But the situation’s less about drugs than, frankly, rampant suicide. These drugs’ risks — legal hassles, family miseries, and very possible lethal overdose — are so notorious that users would need to be in abject despair. Yes, people can be in that much pain, yet we obsess about these mindless chemicals instead. Hardly anyone asks, “Why do we need all these painkillers, anyway?” Or, put another way, “Why is there more pain than ever in America?”

And there is more pain than ever in America. The poor and minorities have always had a rough go, but recently a more favored class, white males, has begun to tumble off the rails. Today, being white and male are the two single greatest risk factors for suicide in the U.S. In fact, white, middle-aged men account for 70 percent of suicides each year.

Some experts describe this trend as deaths from despair, whether by drugs, alcohol, or other means. Nine-tenths of these people occupy a lower socio-economic class, sick at heart, so to speak, over unemployment, poverty, and health concerns. Veterans are at greatest risk. According to a 2014 VA report, twenty commit suicide each day — more than we lose in combat — and two-thirds of them are age fifty or older.

Some people take painkillers for a bad back. Some others take painkillers for a bad life. And sometimes a bad life announces itself as a bad back, if you know what I mean.

Maybe the authorities are aware that this epidemic isn’t just about drugs. I suspect they know it’s about lives made sad and literally painful by values favoring profit over human welfare. It’s harder to address that inequity, though, than to simply pour more money into an extended war on drugs. But when the bottom drops out of a formerly favored class and doesn’t get addressed, there’s big trouble ahead.

Jeff Kane is a physician and is the author of Healing Healthcare: How Doctors and Patients Can Heal Our Sick System.

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