A week ago, over the weekend, I watched the series Dopesick, which tells the story of OxyContin’s launch on the U.S. market. That launch marked the beginning of America’s opioid epidemic, because the company had done an enormous job of rehabilitating the image of opiates:
- They claimed they could be taken in a controlled way (“less than 1% of patients develop addiction”).
- They also insisted that thanks to its new formula, OxyContin didn’t cause the usual euphoric peaks and crashes typical of opioids.
But the most important thing was this: pain itself was denormalized. Through a network of research organizations it funded, Purdue Pharma pushed the idea that pain is the “fifth vital sign”, alongside temperature, pulse, blood pressure, and respiration rate. You’ve probably seen the pain scale — at least I saw it in Scrubs. That’s what became widely used thanks to Purdue’s efforts.
Overall, I liked the series. I especially appreciated that the head of Purdue Pharma wasn’t portrayed as some cartoon villain, but more like an office workaholic obsessed with the idea of “creating a new penicillin,” of “freeing the world from pain.” In one scene, when they’re discussing why it will be hard to push OxyContin in Germany, another employee tells him:
“Germans have a different view of pain. They see it as a natural sign of recovery.”
And I think this line is one of the most important in the series, if you watch it not just as a quasi-documentary about a tragedy in the U.S., but also as a metaphor for what’s happening to people today. I’ve already written about how I’m annoyed by the trendiness of psychotherapy (don’t get me wrong — therapy is great, but therapy as a lifestyle — I’m strongly against that); by “working through everything”; by nonviolent communication and endless “I-statements.” These can be useful tools, just as OxyContin can be an excellent tool for managing pain — say, post-surgical pain.
But the problem is: the phrase “I feel discomfort when you do XYZ” can easily become a way to hide from any criticism, including the kind that’s valuable and helps you grow. Sometimes being able to talk about your feelings and ask people to be gentler, or to shield yourself from criticism, is a necessity — when you simply don’t have the strength. But the temptation to stay in this “self-care mode” permanently is huge. Imagine a button that just switches off all negative impulses. The experience of opioid addicts shows us that the brain will want to press that button constantly.
Unfortunately, just like with opioids, the absence of negative stimuli — the ones that stop people from doing dumb things — can hit back even harder. In the end, sure, you can ask your boss not to give feedback in front of others, not to give it in a harsh tone, not to give negative feedback on Fridays (so you don’t ruin your weekend!). But eventually your boss may lose the ability to give feedback at all, and your growth at work will stall — or worse, your boss will just prefer to work with someone who doesn’t hide behind the “I’m in my safe space” button.
And there’s another important thought — I think it was in the series too, or maybe I heard it elsewhere. Pain is the primary trigger for our empathy. Biologically speaking, plants are alive, but even city dwellers will casually cut flowers or pluck strawberries and pop them into their mouths. Ask the same person to snap a goose’s neck — and the world has just gained another vegetarian. We see a fly caught in a spider’s web, struggling desperately to get out, and we feel its pain and fear — even if half a minute ago we were annoyed by its endless attempts to land on our screen. We watch Discovery Channel and want the gazelle to escape the lion. Then we see the lion starving and want him to catch the gazelle after all.
Pain is a property of life. And if you avoid pain entirely — how are you any different from ChatGPT?