Originally Posted by MoAlpha

The opioid crisis had two main causes, in my opinion:

On the supply side, the pharmas developed a bunch of very potent synthetic opiates and, in order to sell them, promoted two bogus but plausible ideas: 1. that patients with real pain could take opiates without risk of addiction and 2. that time-release pain pills had greatly reduced addictive potential. They marshaled their scientific and sales apparatus and launched a huge campaign to make pain the "5th vital sign" and make every doc and nurse an advocate for its total eradication.

On the demand side, white, working class, America fell into a spiral of despair and social dissolution and embodied it as an epidemic of chronic pain. Of course, the massive influx of dope overflowed the pain population and became an epidemic simple abuse. The mechanisms linking social stress and the inability to suppress or tolerate pain are pretty well worked out at this point, but the concept is still beyond common understanding.

Then, of course, the crooked docs, pharmacies, and pill wholesalers stepped up to facilitate.