It was very disturbing to read the recent Maine Voices column on pain and drug abuse (“Don’t confuse people who have persistent pain with prescription-drug abusers,” Nov. 18).

This commentary could have been written in the 1990s. The author’s arguments are the same as those that led to the dramatic increase in opioid prescriptions for pain that started in that decade, and resulted in the epidemic of opioid abuse that our society is now experiencing. Pain was to be treated at all costs, and it was said that patients taking opioids for pain were not at risk for addiction.

Now we know that is not true. Every day in my practice, I see patients whose addiction started with legitimate prescriptions for pain. In fact, a recent study from Canada reported that among methadone patients, more than 50 percent of women first used opioids as the result of a prescription from a physician.

We have also learned that opioids are not effective for many cases of chronic pain, and that long-term use is often not appropriate.

Chronic pain is a public health crisis, and opioid abuse is also a public health crisis. Health policy and medical practice must deal with both, and must find the appropriate balance between the two. That is not easy. The balance was lost by the medical profession decades ago, and we are still paying the price.

We must address chronic pain and the risk of addiction, and not argue over which side of the equation is “right.”