A Silent Generation Lost to Opioids

Authored by: Clarice Xu

Art by: Allison He

The government’s long campaign of selective incarceration told generations of people that addiction was their fault because they supposedly lacked the gumption to “just say no.” Yet, none of this punitive messaging was true, because many people affected by the crisis were voiceless victims from the beginning of their lives.

Pharmaceutical companies saw the Appalachia region as a gold mine. Many people work in dangerous labor, including coal mining, logging, and factory work, leading to high rates of workplace injury. At the same time, medical care is often limited [1]. Companies discovered that people’s pain could be profitable, and took advantage of it, causing widespread suffering.

Companies such as Purdue Pharma, marketing opioid painkillers, most notably OxyContin, with unprecedented aggressiveness [2]. The company deployed sales representatives to target physicians directly, and circulated promotional materials that misleadingly downplayed the addictive risks of the drug [3]. Yet, Appalachia had already suffered from limited access to healthcare, making them particularly susceptible to aggressive pharmaceutical marketing. Even though lawsuits later forced changes in how painkillers are marketed and prescribed, real justice never came [4]. Because of a new generation of children growing up in households ravaged by substance abuse.  

Between 2020 and 2022, nearly one in eight babies was born exposed to drugs. Studies show that substances like methadone can change the sound of a baby’s cry, since withdrawal creates pain. As these children grow, many face motor-development delays and greater vulnerability to the challenges and adversities that come later in life [5].

The challenges don’t end at birth. As children grow, the impact of the opioid crisis becomes even more serious, especially because so many parents have been lost to overdoses. Between 2011 and 2021, an estimated 321,566 children lost a parent to a drug overdose, according to the National Institute on Drug Abuse [6]. As a result, many children are now being raised by a single sober parent, a grandparent or other relatives or the foster care system.

This loss of parents has left children, families, schools, and entire communities struggling to cope with the aftermath. These children experience higher rates of abuse and neglect than those whose parents do not struggle with addiction. As they grow older, they are more likely to face behavioral challenges, increasing their risk of developing substance-use problems later in life.

Cleaning up the fallout of the opioid crisis will require a long-term, aggressive strategy that spans generations. Regions like Appalachia have already taken important steps, but relying only on settlement dollars for treatment programs or short-term prevention efforts is not enough [7]. When funding focuses solely on current opioid users, it leaves the next generation of innocent victims still scrambling for answers.

Even with more resources available, the government still needs to change the way it talks about addiction. Because the victims are voiceless victims, as no one chooses to develop an opioid addiction. Because for life, they live with the consequences of emotional neglect, disrupted schooling, and limited access to supportive care. They experience a cycle of hardship from birth through adolescence, making it extremely difficult for them to develop resilience in their own adulthood. Therefore, the government needs to focus on creating policies that treat addiction as a public health issue rather than a moral failing. This includes expanding access to trauma-informed care, especially in communities heavily affected by the opioid crisis. Investments should also prioritize early intervention for children and resources that strengthen family stability.

Just like any other illness, opioid addiction can be treated with medical care and, just as importantly, with compassion. When sympathy is missing, resources for care do not flow, and there will be many more generations of voiceless victims.

References:

1. Schalkoff, C. A., Lancaster, K. E., Gaynes, B. N., Wang, V., Pence, B. W., Miller, W. C., & Go, V. F. (2020). The opioid and related drug epidemics in rural Appalachia: A systematic review of populations affected, risk factors, and infectious diseases. Substance Abuse, 41(1), 35–69. https://pubmed.ncbi.nlm.nih.gov/31403903/ 

2. Roberson, P. N. E., Cortez, G., Trull, L. H., & Lenger, K. (2020). In their own words: How opioids have impacted the lives of “everyday” people living in Appalachia. Journal of Appalachian Health, 2(4), 26–36. https://pubmed.ncbi.nlm.nih.gov/35769637/ 

3. Carmichael, T. (2025, July 17). This is how Big Pharma targeted Appalachia and fueled America’s deadliest drug crisis. Appalachian Memories. https://appalachianmemories.org/2025/07/17/this-is-how-big-pharma-targeted-appalachia-and-fueled-americas-deadliest-drug-crisis/ 

4. National Academies of Sciences, Engineering, and Medicine. (2021). High and rising mortality rates among working-age adults. The National Academies Press. https://doi.org/10.17226/25976 

5. West Virginia University Health Sciences. (2023, February 7). WVU study shows number of West Virginia infants exposed to drugs in the womb is 10 times higher than national rate. WVU Today. https://wvutoday.wvu.edu/ 

6. Hawks, L., Bonn, M., Peacock, A., Gorgens, K., Copello, E., Drake, P., & Hedegaard, H. (2024). Estimated number of children who lost a parent to drug overdose in the U.S. from 2011 to 2021. JAMA Psychiatry. Advance online publication. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2818228 

7. McDonagh, M. S., & others. (2025). How not to spend an opioid settlement. JAMA Health Forum. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2759903