Because it's low hanging fruit. Politicians can be "tough" on chronic pain patients and frame it as furthering the battle against the "opioid epidemic" without having to address the actual kraken in the bathtub, which is shady, Chinese bootleg fentanyl flooding the US through our leaky International mail system. The opioid crisis and epidemic of overdoses isn't fueled by Grandma selling off her "extra" 5mg percosets, its coming from illegally smuggled fentanyl being sold illegally on the streets. Chronic pain patients are just a convenient sock puppet for the constant campaign mode our politicians are in, and they don't care who they hurt to get elected or stay in power. Imho.

opioids were over prescribed for years and years with no thought to the consequences - mainly because the person writing the scrip was compensated for it by the drug manufacturers.

this led to tens of thousands of people who became addicted to opioids and lacked the willpower to fight being dope sick to get clean. even once you're clean, relapse is common. the reality is that many people are weak willed - but no one wants to discuss that.

now cheap synthetic opioids are easily mass manufactured in China and Mexico and they are widely available & flood the streets. examples: https://www.youtube.com/@talesfromthestreets/videos & https://www.youtube.com/@examiningportland/videos (there are others but those are the ones I've seen recently).

It may be low, but it's still thousands. I had knee surgery last year and didn't take opiates because I'm at higher risk for addiction.

Your 1% figure comes from misrepresentation of a 'study', pushed by Purdue and others for criminal gain.

The One-Paragraph Letter From 1980 That Fueled the Opioid Crisis

Purdue Pharma, which makes OxyContin, starting using the letter’s data to say that less than one percent of patients treated with opioids became addicted. Pain specialists routinely cited it in their lectures. Porter and Jick’s letter is not the only study whose findings on opioid addiction became taken out of context, but it was one of the most prominent. Jick recently told the AP, “I’m essentially mortified that that letter to the editor was used as an excuse to do what these drug companies did.”

Don't get me wrong, pain is miserable and treatment needs to be better. But around 80% of opioid addictions start with prescriptions for people in genuine pain. What percentage of prescriptees that is, I don't know. But it's not a trivial issue, and it is a very difficult problem to solve.

Because 1% of a few million people is still thousands of them.

Also, I’m not sure if the 1% figure is really that accurate, as it should become much higher when people are on them long term. The problem is that most opioids were prescribed to be safe for long-term use, which wasn’t true.

I'd also imagine at least part of it is the same as how normal people seem to think ADHD people with amphetamine prescriptions are just constantly high.

They don't realize that whatever good feelings they're getting from taking 100mg of amphetamines at once don't apply at all to people chronically on small extended doses.

I'm on a pain management plan that includes an opioid. It requires mandatory 3 month check-ins with my doctor, and my previous pharmacy had a pharmacist that would ask me if I "really needed it". That pharmacy delayed my refills so much sometimes that I would go into withdrawal. And if I called to ask what was going on, they would start asking me why I was so concerned and if I was actually using them.

New pharmacy only has an issue if I pre-emptively request a refill, but even then I just explain my work schedule and issues with remembering to submit the refill and they just hold it until the normal refill date.

How exactly do they count addictions when someone has an ongoing prescription?

It’s fentanyl

New doc here; its a confusing conversation all around. In training management of controlled meds is often an elephant in the room topic with no one really wanting to address it in too much detail. That's mostly because everyone has a different view on it as the powers that be (mostly use state board of pharmacy as guideline) are pretty vague. Most can agree that regular visits (every 3 months at least), drug screens at least yearly, and a controlled use agreement contact between provider and patient is the standard of care. Everything in between that is subject to vary. To further complicate matters medical literature on these meds consistently finds them ineffective for chronic management many disorders including back pain which is in contrast to conventional opinion. Many providers see this as reason enough to sparingly use them. Regardless, in my experience so far whether they truly work or not most patient are very reluctant to stop these medications once started.