You knew addiction had gone fully mainstream when TV ads suddenly appeared offering remedies for an affliction most people had never heard of: Opioid Induced Constipation.

It turns out that along with such dire side effects as abuse, addiction, overdose and death, opioids can leave you really backed up. Physicians wrote 249 million prescriptions for opioid painkillers last year, which has created a big market for stool softeners.

OIC remedies aren’t the only way the pharmaceutical industry profits from addiction. Medications for treating addiction and drugs for reversing overdoses are also big money makers. Analysts quoted by The Washington Post estimate the market for treating opioid side effects with is worth $1 billion a year to Big Pharma.

The connection between pharmaceutical industry profits and America’s addiction crisis isn’t discussed nearly enough, says Vermont Gov. Peter Shumlin.

“We didn’t have this problem until 1990, when Purdue invented OxyContin,” he told a conference of drug court professionals this week. “They said it wasn’t addictive, and got every medical group to embrace it as the new way to treat pain.”

Since then, opioid addiction has skyrocketed, hitting especially hard in rural areas like Vermont. While he was governor, Shumlin saw a sharp rise in small crime in Vermont, with more broken families and more children taken into state custody. It became the defining issue of his governorship, and Shumlin made national headlines two years ago when he devoted his entire state of the state address to the crisis.

Shumlin, who leaves office in January, said Vermont has taken important steps to deal with the addiction epidemic. When someone is arrested on a drug-related charge, a professional assessor gets involved at the booking, when the person is often more open to treatment as an alternative to criminal charges. The state’s drug treatment system has added capacity to eliminate waiting lists. They’ve made anti-overdose rescue kits available to anyone who’ll take them.

Vermont, like Massachusetts and some other states, has also moved to require better training for physicians prescribing painkillers and to limit the number of pills that can be prescribed. But there has been great resistance at every step of the way from Big Pharma’s lobbyists. As state legislatures have considered prescription limits, the industry has funded the “acute pain lobby,” Shumlin said, using sympathetic victims of serious illnesses to argue against measures to restrict the flow of addictive pills.

The pharmaceuticals and health products industry has invested more money lobbying than any other industry, according to the Center for Responsive Politics, spending more than $3.4 billion since 1998 and employing 1,261 lobbyists.

They’ve gotten more than their money’s worth from the federal Food and Drug Administration, Shumlin said. The agency has approved ever more powerful painkillers for ever wider use — even in the face of opposition from the FDA’s staff and advisory boards. Last year, the FDA approved the use of OxyContin on children as young as 11.

“Why do we put up with it?” he asked a large audience of people who spend their days balancing the threat of incarceration with the promise of recovery. “Why don’t we talk about the source?”

“Why don’t we get mad?” he asked. “Why don’t we tell Big Pharma ‘Enough is enough — stop killing Americans?’”

Americans now pay nearly $10 billion a year for prescription painkillers like OxyContin, Vicodin and Percocet, but that’s not its real price. The Centers for Disease Control estimates that more than 165,000 people died from prescription drug overdoses between 1998 and 2014. When people addicted to prescription drugs can no longer find or afford the pills, they turn to heroin or, more recently, the even more powerful fentanyl, and the death toll continues to rise.

States are doing what they can, and some members of Congress are pushing for programs and reforms. But the FDA is still in the pocket of the pharmaceutical lobby — a situation that seems unlikely to change soon. President-elect Donald J. Trump campaigned on a pledge to get federal regulators out of the way of the development of new prescription drugs, including potent, addictive painkillers.

“Pharma stocks went through the roof,” when Trump was elected, Shumlin said. “Wall Street bets on more trouble, brought to you by the FDA.”

The fight against addiction is being waged by thousands of dedicated people, in courtrooms and treatment centers, living rooms and state capitals. They could really use a powerful ally in Washington to help stop addiction at the source — instead of just treating the side effects.

— Rick Holmes writes for GateHouse Media and the MetroWest. He can be reached at rholmes@wickedlocal.com. Like him on Facebook at Holmes & Co, and follow him @HolmesAndCo.