and to some extent the "Big Pharma" boogeyman as well. The Big XXX thing to me has always been a way to blame "them" so that people don't have to take any responsibility for their actions. In most cases there is at least some negligence from big XXXX, but the idea that they pull the strings on puppets who have no control has always bothered me.

In this particular case I've always felt that doctors are using the drugs to treat their patients and are doing what they feel is in their patients best interest. On the other hand their are those with medical licenses who are dispensing pills, knowing full well that they are not treating patients, they are simply selling drugs to addicts.

People like my cousin who is a poster child for the opiod addict have no job skills, no real prospects at anything in life beyond waking up and getting through another day, and have been hooked on something for most of their life (my cousin was drunk or high starting at about 14 and transitioned to coke by 19). This is just the latest form of self medication for her. People like her never had an illness or injury that a doctor prescribed it for her and got her hooked, she got it from the same scumbag in the trailer park that she got pot, coke, meth, whatever from.

Before the big national coverage of the crisis I saw a documentary about a person with a medical license in FL who had a "pain clinic" where dealers from all up and down the east coast and Appalachia would come and buy bags full of pills to take back to their customers. That to me is the face of the crisis, not the sick or injured person under the care of a real doctor.

As for pharma's roll in this, I see it more of whistling past the graveyard than some sort of conspiracy to addict and kill people. Companies incentive their sales reps to sell, sales reps use whatever tactics they know work to get a customer to buy their stuff rather than someone elses stuff. People with medical licenses were buying the stuff and they were filling the need. I struggle with the idea that it is a manufacturers job to not fill market demand for a legal product. Assuming they met all regulatory and legal requirements, were they supposed to say "Oh no, I'm not going to sell you this product because I think you are misusing it"? That's just not realistic.

The real criminals in this are those that are knowingly using their medical licenses to distribute the stuff to people they know are not sick or injured. They are no different than the people that distribute coke, cook meth, whatever...they just have a medical license.