There's a big difference between dying of cirrhosis, heart disease, diabetes, lung cancer, emphysema, etc in middle age and a 19-year-old kid OD'ing a couple of weeks or months after falling down the addiction spiral.
It's not just the number of deaths, it's the impact to society. Line cooks don't steal kitchen equipment to buy booze and smokes. Opiate addiction upends lives in a way that alcohol and tobacco simply do not.
https://www.cdc.gov/motorvehiclesafety/impaired_driving/impa...
>Every day, 28 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver. This is one death every 51 minutes. The annual cost of alcohol-related crashes totals more than $44 billion.
Also, what's the difference between a 19-year-old kid OD'ing a couple of weeks or months after falling down the addiction spiral and a 19-year-old kid dying in a car crash from drinking and driving a couple of weeks or months after falling down the addiction spiral (of alcohol)?
Keep in mind any solution, including painkiller cutbacks, is proven to result in increased heroin usage (see: oxycontin reformulation in the early 2000's. By the end if the decade all abusable oxycontin would be gone.)
People are dying because heroin is illegal. Full stop. Fentanyl cut in heroin is a result of a broken approach.