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As part of what we term the crimedical cycle, a population’s behaviors fluctuate between periods of medicalization and criminalization. Strengths-based theory is underdeveloped in addiction medicine, despite it having deep roots in the treatment field. This ongoing omission engenders narratives around opioid use that congeal to propel the stigmatization, over-policing, economic marginalization, and poor health of those who use opioids. This article discusses the historical trajectory of views and attitudes on opioid use and presents a model that advances strengths-based approaches to engaging this population.