Most, if not all, of us know someone who has been prescribed a pain reliever. If you’ve had your wisdom teeth out, they’re probably somewhere in your medicine cabinet. And if you know anything about what is going on in our community, you must know that these pain relievers have been a catapult for the opioid epidemic that is plaguing the Cape.

According to statistics released by the state in 2015, Barnstable County ranked number one in overdose fatalities. Along with that, a Cape Cod Times article highlighted the statistics as well as a widespread obituary to Cape Codders who have died from addiction. These aren’t people who can be put in one category: they range from 19-57 years-old, from all different backgrounds and families and circumstances. What brings them all in one collective article is their horrible fate from heroin addiction.

As Cape Codders, we pride ourselves on knowing the Cape better than any of these visitors who come here for three months or two weeks or a few days. We make it through February–therefore we are real. However, a lot of us real ones seem to ignore the fact that we have a record of 30.3 deaths per 100,000 people from overdoses. Do we know the real cape if we don’t know this or if we aren’t paying attention to it? As much as our beaches and our cute little coffee shops make our home, this makes our community what it is too.

Heroin addiction can be tough to talk about, but a conversation is necessary. No one wants to become an addict and yet we seem to have more than we know what to do with (though, to be fair, we don’t seem to know what to do with even just one). Heroin addiction begs so many questions: how do we prevent it? Should we scare people to not try these substances? Simply informing doesn’t seem to work, so would scaring even be the answer? Those videos from elementary school that aimed to horrify us wear off after a few years.

And maybe information and scare tactics may not be even part of the solution if the substances are coming from doctors’ offices. Doctors are supposed to be people we a trust– literally, with our lives. From a young age, we go to the doctor at least once a year and constantly told not to be scared by our caregivers. As a young child (and fewer of us now), we may have feared the doctor simply on the account that shots might be part of the visit. Ironically, now the issue is that you might be putting a needle in your own arm because of the pills your doctor prescribes. In what world is one of your biggest fears as a child now what you’re brought to do daily possibly because of the professionals who caused the fear in the first place.

Many studies connect addiction to opioid drugs to later use of heroin. So the oxycontin from your wisdom tooth extraction? According to the National Institute on Drug Abuse, “The emergence of chemical tolerance toward prescribed opioids, perhaps combined in a smaller number of cases with an increasing difficulty in obtaining these medications illegally, may in some instances explain the transition to abuse of heroin, which is cheaper and in some communities easier to obtain than prescription opioids.”

Within the past year, a Cape doctor has had his license suspended for over-prescription of opioid drugs. According to a Cape Cod Times article, Conrad Benoit’s license, which he has had since 1991, was taken away by the state Board of Registration in Medicine because they found that he posed “an immediate and serious threat to the public health, safety and welfare.” His attorney, Stephen Patrick Harten, said that, “It’s not about whether Dr. Benoit over-prescribed to a small group of his patients, it’s about whether the alleged over-prescription warranted an automatic suspension.” It seems Harten isn’t denying the over-prescription, just arguing the suspension. And, while it can’t be explicitly determined that Benoit’s prescriptions have directly caused addiction, but, clearly the over-prescription of drugs by doctors is an issue that the Board finds relevant and important. As real Cape Codders, we should too.

According to a study entitled Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research by the Institute of Medicine, there are between 26 and 34 million people in the world abusing opioids. From those numbers, more than 2 million are Americans abusing prescription opioids.

Matt Ganem, a Boston local, a self-described oxycontin and heroin addict, is now eight-years clean. Today, he works to spread awareness and help for addicts through videos and interviews and poems. In one of his videos,“The science of opioid withdrawal,” he describes that becoming clean is like “coming undone at the seams; crawling out of your skin; I mean it’s basically like, you know, you’re living in hell.” The title of one of Ganem’s interviews with the Boston Herald says it all: Staying away from what the doctor prescribes.

On the science-side of addiction, opioid addiction happens once your body is used to having the input from the drugs, as it will stop creating its own pain receptors. If the addicts chose to become clean once they stop taking the opioids, even the smallest pain will be excruciating to them–so it’s a vicious cycle: try to get clean, feel horrid pain and look to heroin to numb yourself again. It’s a cycle that we can’t ignore, though we have done our best to try. As real Cape Codders, every part of our community should mean something to us, including this.