When someone dies from an overdose, everyone wants someone to be blamed. If only it were that simple.

When a famous person dies, the Internet inevitably speaks. Tributes fill Instagram feeds. Good memories are told on Facebook. News articles tell the story of the ups and downs of a life. After a celebrity’s fatal overdose, something else is also happening in the comments: a blame game.

On Instagram posts and news articles about the model Presley Gerber dies of suspected overdose at age 27fans, haters, and crusaders alike speculated on whose fault it was. Some blamed Gerber’s famous parents, Cindy Crawford and Rande Gerber. Others said Presley was solely responsible. And still others have highlighted the toxicity of the modeling industry or the dangers of alternative therapies for drug addiction – notably the psychedelic, ibogaine – that he tried. Actor Hayden Panettiere’s fatal overdose sparked theories that his death was not an accident, but intentional poisoning; suspicion turned to her boyfriend and criticism of her ex-mother was renewed.

When someone dies of an overdose, those left behind – whether fans, family or friends – want answers, even if there aren’t any. Nadia Bowers knows this impulse all too well. After her sister, Sasha, died at age 44 of a fentanyl overdose in 2015, Bowers “wanted the simplicity of a crime,” she told me. “I wanted clear bad, clear good – a binary.”

Bowers knew who she blamed: “the dealer,” the nameless, faceless person, the one who sold her sister the fentanyl that killed her. After his sister’s death, Bowers began researching this person and writing letters to her, which became the heart of his new debut memoir, Dear dealer.

But even though Bowers’ rage and grief focused on the dealer, she knew that when it comes to addiction and overdose, that black-and-white thinking “is just never going to be complete, because it’s a life,” she said.

In the case of his sister, the fentanyl dealer was to blame, Bowers said. But even if she wanted to, deaths from addiction and overdoses aren’t that simple.

Overdoses are coming back to the forefront

Fatal overdoses have fallen into the spotlight as the number of annual deaths has declined from its peak of more than 107,000 in 2022. Despite the decline over the past three years, tens of thousands of people still die each year from overdoses. 70,000 deaths in 2025 alone. The majority of those deaths were from opioids, a class of addictive drugs that includes prescriptions such as oxycodone and morphine, and illicit drugs such as heroin and the highly potent fentanyl that killed Bowers’ sister. “It’s far from over,” she says of the opioid epidemic.

There is much debate about what turned the tide of fatal overdoses. Researchers credit a combination of the proliferation of the anti-overdose drug naloxone; changes in the drug supply (including the rise of fentanyl and xylazine, which have driven some opioid users away and led to the deaths of others); and an increase in harm reduction efforts driven by greater awareness of the problem.

Both Panettiere and Gerber have been vocal about their struggles with addiction, and experts say that can be helpful in dispelling the stigma that drives many drug users into isolation. But their deaths highlight another pressure: It’s hard for anyone who has stopped using drugs to admit they’ve relapsed, and “if you’re a public figure who’s under the microscope like these guys are, how does that fit into the PR agenda?” says Brendan Little, co-founder and executive director of the nonprofit organization Halo Initiativeswhich supports Boston families after the loss of loved ones to overdose. This can cause people to isolate themselves more… a key risk factor for fatal overdoses.

And after a drug-related death, loved ones can also feel alone, just when they need support the most. Little, who lost his son to an overdose, “all these people came to me when my son was struggling,” he says. “And then he died, and it was like crickets.” In the absence of support, family members may turn to their own risky coping mechanisms. Addiction is “a family affair,” he says. There is a genetic risk, and a person’s struggle with drug addiction also affects those close to them. “People want to blame someone, but often those who are blamed are those who are not properly served.”

Why we look for someone to blame

It’s a natural instinct, Dr Nora Volkow, director of the National Institute on Drug Abuse, told me. “I think it’s a very human thing that we try to identify the cause of something that has consequences,” she says. “If you understand the cause, then you are prepared to avoid a similar situation.” Just as Bowers wanted to treat his sister’s death as a crime committed by a perpetrator, finding a cause can seem like a step toward preventing the same thing from happening again.

Once Bowers learned that fentanyl caused her sister’s fatal overdose, “it was like, ‘Oh, there was a ‘sniper’ and someone took him out,'” she says. “I was right about that, and it took away any chance of recovery.” Additionally, in the aftermath of her sister’s death, anger and the target of her rage were “motivating and energizing,” she says.

Of course there is It’s the truth: Fentanyl “was the technical reason” why Sasha died, according to her autopsy, Bowers notes. “It’s okay to be angry…and we should be angry. And the fact that these drugs are so available is a systems problem, and the fact that there is a demand is a human problem: people are suffering,” Bowers says. But, through writing her book and mourning her sister, Bowers came to believe that the causes of overdose deaths go beyond an individual, a family, or a drug.

Maybe pointing fingers helps alleviate our own guilt, Justin Phillipsfounder of the Indiana-based nonprofit Overdose Lifeline, tells me. Amid the countless articles about Panettiere’s death, Phillips thought, “She was suffering, and maybe that’s part of our guilt and why we look for someone to blame: no one stepped in and tried to help her.” »

Stigma can prevent people from helping an addicted person because “we don’t want to get too close and be vulnerable,” Phillips says. In her experience, simply expressing concern can have a social cost. “People are much more willing to join the Symphony board than they are to join the Overdose Lifeline board,” Phillips adds.

So there is a sense of safety in creating distance between us and an overdose death through accusations. “There’s always this feeling of blaming someone else because that stops it from happening to me,” Volkow says. “As long as I can actually point the finger at someone who did something wrong, it creates peace of mind that (what happened to him) won’t happen to me.”

It’s a self-protective impulse, but one that can inadvertently perpetuate stigma and the idea that addiction is a moral failing — an idea that addiction experts, including those I’ve spoken to, view as harmful.

What is the criticism about addiction?

When it comes to deaths from addiction and overdose, the culprits – like the risk factors – are numerous and intertwined.

As Volkow says: “Who do you blame? The person who takes the medicine? Do you blame the dealer who sold them the medicine? Do you blame the health care system for not examining or providing support for this person? Do you blame the family for not paying attention?”

All of these factors can contribute to the death of an individual. But they often come with “a lot of misunderstandings about what addiction is,” Volkow says.

Chief among them is the idea that “a person takes drugs because they choose to take drugs,” she says. When a person is not addicted to a substance, they make conscious decisions, such as drinking a glass of wine or taking painkillers. But drugs — especially opioids like those involved in the deaths of Gerber and Panettiere — can take away that agency as people become chemically dependent on them, Volkow says. “It’s the whole process where you move to a situation where taking this drug becomes an automatic, compulsive behavior,” Volkow says. “It’s essentially the pathology of addiction.”

The risks of addiction – and therefore overdose – also vary considerably and are not all controllable or predictable. Research suggests that between 40% and 60% of the risk of addiction is genetic and beyond the control of an individual. Mental health problems are also a major risk factor. Panettiere spoke openly about suffering severe postpartum depression and reliance on opioids and alcohol to cope. Gerber describe dependent on both prescription medications, such as Xanax, and illicit drugs amid his long-standing depression. While from the outside, people who use drugs are often criticized for “lacking self-control or having poor moral values…the reality is that many of these people are in great pain,” Volkow says.

And as Bowers says: “The medicine does something. It’s actually a solution to something” – at least temporarily. Medications, especially opioids, do indeed relieve pain that people have not found any other way to relieve. But they can also lead to addiction, which is an illness, even if people don’t perceive or treat it as such.

“Addiction, depending on its severity, needs to be treated very, very aggressively,” Volkow says. “If you’re diagnosed with cancer, you don’t stop and say, ‘Maybe (we treat it), maybe not.’ In fact, you’re intervening with the most powerful tools we have – but that’s not how we conceptualize addiction. »

And it’s not just that those around people struggling with addiction don’t treat it like an illness; this is often not the case with the healthcare system. Insurance companies don’t pay doctors so much for treating addiction as well as other illnesses, Volkow says. This, in turn, deters doctors from treating it, leaving the door open to less scrupulous, less…