With racist GOP governors doing everything they can to discredit the first African American President. One of the ways has been to refuse to expand medicaid, most have gone as far as to throw thousands of poor people off of medicaid to overburden the ACA (such as my medicaid expulsion in Wisconsin).
A second issue is high deductibles.
The third is big pharma.
All of these have worked to strip pain medication from thousands of people.
Dealing with constant pain is maddening. Some (maybe eventually all) turn to illegal drugs to combat pain.
Heroin is the cheapest effective choice.
People on state medical aid get tested for illegal drugs, one hint of a trace and off you go.
While over prescription of opiates has been a contributing factor, large blocks of people suddenly without medication is a greater factor.
My brother is one of those afflicted.
Add to all this, the easiest most cost effective way to fight heroin addiction is medical marijuana. But then methadone (synthetic heroin, same addictive qualities, a hell of a lot more expensive, made by big pharma) would be hard to sell,