> because they are looking for a way to make their situation in life not hurt so much. It's what their friends/family do.

This part still puzzles me, because the opioid crisis is really well known about. How does "my life is shitty, I'll improve it by starting on the drugs that are famous for ruining lives" add up for anyone? Is "but cousin Bert does it and seems to be OK so far, so I can too" really that persuasive? Or maybe it's all ultimately down to prescription pills, except they might be somebody else's leftover ones, and starting there seems OK because it's medical and safe-looking.

From conversations I've had with users, when you have internal voice that you can't make stop without the use of drugs then you look for anything. My life is shitty has many meanings and might be difficult for someone to understand. If you have no personal experience, then I'd suggest using softer tone than trying to assume nobody else has problems because you can't empathize. Getting to the point of being comfortably numb so that you're not thinking about anything can be quite a relief

Well, telling me I can't empathize is irritating, and isn't much of an explanation. But, I'm not sure what I was asking. Well OK, I think it's this: I don't believe that statistically, people saying "I think I'll try opioids because I feel terrible" can be a driver of the epidemic, because on aggregate people wouldn't. Sure, some people feel more terrible than others, and some are more persuaded by circumstantial effects than others (including somebody I know who picked up an addiction from her boyfriend despite being a super-rational psychology student who should have known better). But these things can't be the main cause, because people in general do know better than to begin, and to have an "internal voice that you can't make stop", prior to addiction, can't be very common. Statistically, it's got to be something else. I'll go with the medical pill-pushing theory for now.

> From conversations I've had with users, when you have internal voice that you can't make stop without the use of drugs then you look for anything.

I present to you the definition of sane: 1. : proceeding from a sound mind : rational. 2. : mentally sound. especially : able to anticipate and appraise the effect of one's actions.

Being over-dramatic about it doesn't change the fact that the person doing the self-harm is not in their best condition. Yes, I have been there with alcohol and drugs abuse, I have lost friends and family members too. Treating them as people capable of deciding with their best interest in mind definitely didn't help me help them.

Over-prescription is/was bad. I have many friends who've had sports-related surgeries (ACL repair, joint replacements in their 50s, etc). Almost all received several weeks of opioids to take at home. Very few actually used them all, leaving them with a bottle nearly full of dangerous, addictive drugs.

Most of them transition to OTC pain management ASAP because they know the risks of addiction. I imagine people who don't know better take the full course, because that's what was prescribed, and end up at more risk for addiction?

> A large percentage of opioid addiction came from being prescribed by a doctor.

I think that's the main factor which differentiates the US from the rest of the world. IANAD, but as far as I know at least here in Europe opioid painkillers are reserved for the terminally ill (mostly cancer), and the US shows why "normalizing" their use is a very bad idea...

They’ve definitely been overprescribed here (and the drug companies making the opioids pushed them knowing they were addictive, and downplayed the risks). One of my best friends’ cousins died in his 20s of a heroin overdose. He got addicted to opioids after being prescribed painkillers following a shoulder surgery. He was a baseball player, in good shape, young.

To me, overdose deaths in people prescribed them by doctors are some of the worst. They’re frequently in younger individuals, meaning more life cut short; they were indirectly caused by a profession whose ethos is “first, do no harm”. To me, it is a sign that something has gone badly wrong in the medical profession and society at large and sows major distrust in our institutions.

Opioids aren't even used post-surgery for pain management? I have to think they are at least used in hospitals still. Maybe not prescribed as much for home use...

They are not, not even in other parts of the world. It is also very rare in Asia. Folks tough it up and are fine, as the risks of opioids are not worth it