How did the opioid crisis transition from prescription medications to illegal drug use, and what role did various institutions play in this crisis?

The opioid crisis evolved through a chain of institutional failures and profit-driven decisions. Purdue Pharma deliberately misled the public about opioid addiction risks, while the FDA failed to provide adequate oversight. Insurance companies compounded the problem by creating barriers to proper treatment. When authorities finally tightened prescription regulations, patients who had become dependent on medications like OxyContin were forced to seek illegal alternatives like heroin on the streets. This transition was particularly devastating for populations like veterans, who received excessive prescriptions through the VA system and later found themselves navigating dangerous illegal drug markets despite having no prior experience with street drugs.