How accurate is "Kevin"?

How accurate is "Kevin"?
by Patti F. Boyle, LMHC

Seattle’s own hip-hop artists, Macklemore and Ryan Lewis, with guest singer Leon Bridges, give us “Kevin”, a song inspired by the untimely  death of  Macklemore’s  friend who died of an oxycontin overdose at the age of twenty-one.  Macklemore has also been candid about his own struggle with addiction, and his own “dabbling” with oxycontin.

Lyrically, Macklemore’s “Kevin” describes his friend’s descent into the self-hating, ravages of addiction, yet clearly “Kevin” is a statement against the attitude and actions of the medical profession, pharmaceutical companies, and “the country that spend trillions fighting the war they supplying themselves”.  Macklemore blatantly blames the over-prescribing of drugs as well as the self-imposed blindness of a system that advocates the use of prescription drugs that are not only highly addictive, but also responsible for the death of many who trust in their doctors’ care. 

“Doctor, please, give me a dose of the American dream
Put down the pen and look in my eyes
We’re in the waiting room and something ain’t right
All this is on you, we’re overprescribed”

Macklemore may be speaking out as one, but his assertion that doctor prescribed medications are “killing me”, or us, is devastatingly accurate.  

Forty-six Americans die each day from prescription opioid overdoses -- two deaths an hour, and in 2013, opioid overdose was the leading cause of injury death in the US, outnumbering those due to motor vehicle crashes, and far exceeding the number of deaths from any other drug, licit or illicit (ASAM, 2015; U.S. Dept. of Health).  Yet, writing scripts for these drugs is legal, and is often a first line treatment for pain. 

“And now my little brother is in the sky
From a pill that a doctor prescribed
That a drug deal a million dollar industry supplied…”

The problem of prescription drug abuse is complex, and there are multiple drivers of the problem. There is the problem of doctors and clinics prescribing the drugs without any agency, government or otherwise, offering oversight to curb inappropriate prescribing. There is the problem of  insurance benefits that allow for consistent payment of opioid medications  because these are inexpensive, and not covering non‐opioid and non‐pharmacological therapies.  Additionally, people believe in and trust their doctors as well as assume that prescription drugs are not harmful, and both factors are associated with increased use.  

“Got anxiety, better go and give him a Xanax
Focus, give him Adderall, sleep, give him Ambien
Till he’s walkin’ ‘round the city lookin’ like a mannequin
Ups and downs, shootin’ up prescriptions that you’re handing him
So America is it really worth it, I’m asking you?”

There is also the immense power of pharmaceutical companies. According to Forbes (2015), healthcare technology has always been one of the most lucrative industries in the U.S., and within the broader healthcare technology category, “the superstars of profitability go to major and generic pharmaceutical companies”.  

Although we are all familiar with advertisements boasting the benefits of pharmaceutical drugs, these companies also promote their wares directly to doctors, and offer incentives for doctors to prescribe.  The drug manufacturers spent $4.5 billion marketing prescription drugs directly to consumers in 2014, yet spending on consumer ads is just a fraction of what the industry spends marketing directly to health care providers. When pharmaceutical companies dropped to spending $3.5 billion on direct-to- consumers in 2012, they spent $24 billion promoting their wares directly to doctors (The Washington Post, March 23, 2015). This should come as no surprise given the social acceptability for using medications for all kinds of purposes, which has created the availability of medications, in general, and opioid analgesics in particular.

“Doctor, your methods, any of your methods
Can’t cure my disease without killing me
You’re killing me, you’re killing me…”

As a mental health therapist, I have seen too many peoples’ lives destroyed by addiction- smart, capable people like you and I- students, professionals, athletes, artists, mothers and fathers- and I am also aware of the millions of people who believe their mental and emotional difficulties will be “fixed” by the meds their practitioners prescribe– the antidepressants, the anti-anxiety medicines-  yet they continue to suffer silently and shamefully because these medicines cannot “fix” their relationships, their jobs, their families, or their fears.  

For these reasons, and through Macklemore’s inspiration, I ask you to have compassion for those who have fallen into addiction; the condition is complex and much greater than the addicted individuals we harshly judge.  And remember the U.S. has accepted and embraced the use of medication for many problems in life, and these problems can be approached and remedied through other methods that do not involve a pill.  And last but not lease, I ask you to have patience.  Our pain and our problems are often years in the making, and repairing them will require great effort, time, insight and practice.

Listen to "Kevin" by Macklemore & Ryan Lewis at