The new painkiller Zohydro has kicked up a lot of controversy lately.

It’s made from pure Hydrocodone, with no added substance like Tylenol. It’s considered less toxic to the livers of chronic pain patients but also potentially more addictive. Massachusetts Governor Deval Patrick tried to ban the drug and, when a court struck that down, he issued restrictions around prescribing Zohydro.

But pain and addiction specialist Yngvild Olsen argues in the New England Journal of Medicine that this dilemma goes beyond any one opiate medication.