The opioid ‘epidemic’ is not really an epidemic at all. It is an unfortunate, but predictable outcome. At the turn of the century, the cry was to make pain the 5th vital sign and JCAHO released pain standards to be used after much public outcry and a national desire to address pain. Mostly short acting opioids existed then and pharma responded with more meds and even created ‘abuse deterrent’ agents to help avoid illicit behavior. The race was on to treat pain.