Opioid addiction is now replacing cocaine and heroin as the gravest addiction menace. My wife, who was (until retirement a couple of years ago) a retail pharmacist in the DC suburbs, saw evidence of this. In Appalachia, such as West Virginia and Kentucky - and, yes, even in the DC region - some doctors had gotten lazy about earning a living and had allowed themselves to become licensed drug pushers. In some cases their patients began with genuine ailments or surgery that required painkillers, in some other instances the patients had previous been using street drugs. One attraction to the addicts is that a legal defense is infinitely easier when the narcotic is prescribed by a bona fide physician who can at least fake a reason in medical jargon (and this is not limited to narcotics - there is also a lively traffic in Adderal and other drugs of abuse), another reason is that (unlike street drugs) prescription drugs purchased at a real apothecary are assured of being uncontaminated and of a consistent strength.
Efforts have been made to discourage this sort of pill pushing by inducing pharmacies to stop carrying certain prescription painkillers, but that only drove addicts to travel farther and farther to get their prescriptions filled. My wife was seeing, just outside DC, pickup trucks loaded with youthful prescription addicts park in front of her pharmacy (where management persisted in honoring such prescriptions when the CVS chain refused them), all the addicts have prescriptions for the same drug, all for the maximum dosage allowed by law on a prescription, all written by the same doctor in West Virginia or Kentucky. These people had endured an entire day on the back of a truck, no matter the weather, just to get their drugs. My wife counted up the addicts and figured at one point that a particular doctor, who was seeing these "patients" on a monthly basis (because a narcotics prescription was good for only a month), was writing so many prescriptions that he had barely enough time to count their money and write the prescriptions - with no time to check their physical condition.
Oxycontin turns out to be more dangerous and more addictive than heroin. But even heroin and cocaine are enormous difficult to break away from. The usual story, told a thousand times with slight variations, is of someone in the family, usually a young adult, spending four or six or a dozen weeks in a rehab facility, whether it resembles a spa, a hospital, or a concentration camp, and coming home, bright-eyed and bushy-tailed and declaring loudly and sincerely that never again will they be enslaved by drugs. And then, within a few hours of returning home, they get a phone call from an old classmate who invites them on a drive around the neighborhood, and all those good intentions are blown to hell in less than a day.