A problem is a lot of heavy addicts fully accept that they’ll die from it. It’s like closing your eyes while driving or playing Russian roulette once a week. There’s no guarantee you’ll die that time, but it’s likely going to happen someday unless someone intervenes or your life changes in a way that you no longer want to take that gamble.

Treating opiate addiction as someone on the path to suicide would be very different than framing them as a criminal or hopelessly diseased (the “progressive” model of addiction that took over the criminal model). But clearly there’s a lot of opposition to that idea, even here.

Some people hide their addiction well. Some don’t and are surrounded by friends and family who are aware of their struggle but don’t know how to help. It’s in many cases less surprising than people want to think.