The "war on drugs", and the racially motivated moral panic about crack cocaine and addiction created a social attitude that casts addiction as a moral failing
Inadequate safety net healthcare provisions lead people to the cheapest treatment option, generic opiates fit this bill
Here's some blog posts arguing the ACA actually increased the severity of the opioid crisis:
https://spottedtoad.wordpress.com/2017/03/27/some-stronger-e...
https://spottedtoad.wordpress.com/2017/03/28/its-opioids-not...
I'm (nevertheeless) pro-universal healthcare, but our idea of healthcare should probably not include these drugs in any but the most extreme and limited circumstances (like, I'm lying in a hospital bed). They're too dangerous.
Having doctors actively prescribe them, under incentives from pharma companies to sell them, seems to me predatory in the same way we think of street dealers stalking schoolyards as predatory.
Chris Arnade has done a great job documenting the crises at a personal level. I highly recommend checking out some of his articles and tweetstorms. It's gut-wrenching stuff (and obviously the problem goes way deeper than simple access).
But pharma/doctors/govt pushing drugs isn't helping, and is probably making it much worse.
And honestly, the correct answer (in my opinion) is that one should do both. As much as I'd like to believe better in society, the truth is that not everyone thinks things through. Not everyone gains information before they do stuff.
Some drugs should have restrictions. Age limits are prudent, for example. I don't trust folks to take most prescription drugs correctly. Antibiotics and most treatment-only drugs are like this.
I'd rather folks do opium than heroin or opiate pills. If there is still a market for them after legalisation, I'd rather the opiate pills that are available to the public be the mild variety. Push folks to do occasional cocaine rather than crack. Avoid meth if possible, mostly because it is hard on folks. Heroin or anything else that one injects are only available at a clinic, where you have to consume there.
And above all, drug addiction treated like a medical condition... and free of charge.
1. Crack has a lighter sentence than meth does despite meth being a "white" drug and crack being a "black" drug.
2. America has always casted failure as a moral failing. Its the basis of Calvinism. It has nothing to do with the war on drugs.
3. The epidemic is new. In the 40s, 50s, 60s, when healthcare was much worse, you didn't see this level of addiction to opiates. Easier access to opiates means better access to healthcare which is the problem.
Yes, this epidemic is new, but drug epidemics aren't. This one is likely more widespread because of widespread use.
But this is most pronounced in the US. Other countries with good-or-better access to healthcare don't have nearly the same problems as the US [1]. I think it lies more in the way we treat folks when they are sick: Turning to opiods instead of other drugs (a combination of ibuprofin and paracet/tylenol is a pretty standard pain treatment here). Not actually giving folks time off when they are sick and injured. Sure, you have the FMLA, but that doesn't exactly let folks pay their bills. We (the US) could also do things like talk to patients and/or their families about ways to handle the pain, what to do if the pain relief wears off, prescribe differently so that it isn't wearing off. We could make sure to have realistic conversations about addiction. And the drug companies could be upfront about this. Lastly, we could provide addiction help, treating it with time off in a manner similar to simply being sick.
[1]https://www.washingtonpost.com/news/wonk/wp/2017/03/15/ameri...
Sam ran the podcast circuit awhile back if you want to listen to his story. I found out about it via Russ Roberts' Econ Talk. http://www.econtalk.org/archives/2017/01/sam_quinones_on.htm...
That is what makes the USA unique - it's almost impossible to be prescribed strong opiates anywhere else in the world, let alone to be told that they're safe.
You know something is prevalent when the drugs to treat its side effects are worthy of prime time advertising.
Well, we're one of only two countries in the world that allow direct to consumer advertising for drugs at all, so your statement is probably true.
(New Zealand is the other one for those curious, with Canada having some limited things they allow).
What the other poster is talking about is the reaction to someone being hooked, looking the other way and/or not treating it as a mental health issue and putting them in rehab instead of jail.
Then, imo, if you really want to get into it, destabilization in Mexico has created the actual heroin epidemic we see now, as the pill mills and doctors involved have had their operations closed.
"By 2002, death certificates listed opioid analgesic poisoning as a cause of death more commonly than heroin or cocaine."
Also if you read "Dreamland" 80% of heroin addicts started addiction with prescribed drugs.
If those people were on methadone instead, for example, hundreds of thousands of people who are now dead would still be alive.