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Both. Some doctors are directly in the pockets of big pharma and the insurance industry and just over-prescribe whatever they're told to. Others over-prescribe from pressure from their patients either for a quick fix of whatever painkillers they're hooked on or are just insistent on getting prescribed whatever meds they see advertised on TV, and a fear of losing their patients to another doctor who will gladly blindly prescribe whatever they ask anyway.
Some just don't know any better and just push whatever they can to get the patient out of the office as quickly as possible so they can move onto the next one, and some patients refuse to take their meds properly, leading them to just get sick again and need even more.
Irresponsibility all around, basically. There's no innocents here.