Pain

A reminder to those who dismiss the use of opioids for pain as unneeded, while ignoring that all those stories of people "addicted" after their docs gave them a mild narcotic for pain were probably exaggerating their pain to get the narcotic in the first place.

and most of the overdose deaths were from Fentanyl,

The drug is still legally prescribed for rare cases of severe pain, but most of thedeaths are tied to illicit forms of the drug coming from China and Mexico. 

and this doesn't note overdoses from medicine stolen from those needing pain pills.

When I worked in Minnesota, we had two such deaths: One, a drug abuser who stole her cousin's MSContin, another a teenager at a party given morphine by another teen who took it from her grandmother's morphine syrup for breakthrough pain.

Those who need narcotic pain relief can be managed on a stable dosage, and function normally. Get rid of the pain and you can wean them off.

Those who take it to get high keep increasing the dosage until they get a bigger high, and often have social dysfunction. They don't just take opioids, but often had problems controlling their use of alcohol, marijuana, and tranquillizers, but if opioids are available, they are the drug of choice because they give you such a nice "high".

This article discusses the subtle difference (subtle because we sometimes treat people who have chronic pain and addiction problems).

Addiction is a biological and psychological condition that compels a person to satisfy their need for a particular stimulus and to keep satisfying it, no matter what.

It is a compulsive behavior that demands more and more drugs, regardless of the consequences that lead to dysfunction. A person who is addicted to opioids has a disease that undermines optimal function and drives one to compulsively use a drug, despite the negative consequences.

The pain patient who is effectively treated with opioids finds life restored-even if he is dependent on them. With the pain muted by stable and steady controlled use of long-acting opioids, a patient can reclaim his life, go back to work, return to family life, and pursue favorite pastimes.

Dependence is a physical state that occurs when the lack of a drug causes the body to have a reaction. Physical dependence is solely a physical state indicating that the body has grown so adapted to having the drug present that sudden removal of it will lead to negative consequences such as a withdrawal reaction..

.The difference between a patient with opioid addiction and a patient who is dependent on opioids for chronic pain is simple. The opioid-dependent patient with chronic pain has improved function with his use of the drugs and the patient with opioid addiction does not.

------------------
Update:

LATimes article on alcohol, opioids and suicide deaths.

mainly in rural whites, laid off because they live in areas where jobs have decreased.