About halfway through the second quarter of Sunday night’s game, a black-and-white ad snuck in, lecturing Americans gorging on nachos and beer about something absolutely no one wants to think about while gorging on nachos and beer: constipation.
The ad features a man gloomily having coffee. He glances over his shoulder when a toilet flushes from a nearby bathroom, from which emerges a grinning man. “Opiods block pain signals but can also block activity in the bowel,” our narrator informs us, as our hero scrambles onto the streets, searching for some relief.
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This a wildly unsexy issue to take on, which is no doubt why many viewers expressed their confusion over the ad on Twitter shortly after it aired. And yet it highlights a growing—and serious—issue in America, as the Washington Post’s Wonkblog pointed out Monday morning. Opioids include heroin, morphine, and prescription pain relievers (think Oxycontin and Vicodin), and their use (and, often, subsequent abuse) is rising not only in America but all over the world. In 2012, 2.1 million Americans were addicted to opioids. Between 1999 and 2011, opioid-overdose deaths jumped 300 percent, according to the CDC, with more than 47,000 Americans dying from an overdose in 2014 alone. Worryingly, half a million Americans (and quickly rising) have a heroin addiction; users often say their gateway into heroin was prescription opioids. And just a few days ago, New Hampshire authorities noticed a troubling spike in overdose deaths from fentanyl, an opioid that is 100 times more powerful than morphine and 50 times stronger than heroin.
Opioids have become such a problem that federal health agencies and the White House have become invested. The White House got involved, too, announcing $133 million in funding to address opioid addiction—which falls into the camp of that now-infamous Super Bowl ad—as well as increasing the use of naloxone, which helps to reverse the symptoms of a drug overdose. And it doesn’t hurt that Secretary of Agriculture Tom Vilsack grew up with a parent with a crippling pill addiction, making it a personal mission for him to see to it that the opioid epidemic gets as much airtime as possible.
Which brings us back to that constipation ad. Opioids chemically change bowel movement, often toward the uncomfortable territory. With a growing population of Americans popping pain meds, more people are experiencing constipation. Enter Movantik, a recently approved opioid constipation drug that’s been making subtle appearances on Sunday football commercial breaks but really got America talking last night.
It’s a smart strategy to dealing with an epidemic, and one the Obama administration and health officials hope brings a largely silent issue front and center: If it takes a painfully awkward, smirk-inducing ad, well, so be it.
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This article originally appeared on nymag.com