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In my country you just tell the doc that you want opioids and you get them. What's funny despite of that there is literally no problem with opioid addictions. It must be combination of other factors like poverty and lack of education etc. that combined with opioids cause the problem.
It's always interconnected.
People do drugs in general more often when their life situations necessitate feeling like they need the help. It's a coping mechanism. The only reason why we attack drug usage with such fervor compared to other, more socially acceptable things, is because they have a faster, more immediate, and more drastic effect.
When you feel your life is going well -- work is good, you're not crunched for money, your housing is stable, your diet is good, etc. you rarely feel the need for any kind of relief. When things start getting shaky or insecure, that kind of escapism can provide relief to people. The downside obviously is that a lot of things can be addiction-forming and cause a feedback loop where the drug use makes the overall situation worse, which feeds the drug use, which makes the overall situation worse, etc...
There are certainly people who kick off that cycle who weren't necessarily doing so as some kind of escapism, but that brings us neatly back to the discussion about opioid abuse in general. You use them to solve a pain problem, you become addicted, and it snowballs.
So it's easier to target the symptom of drug use than it is to address the underlying causes of financial, housing, food, and general life instability. Especially because in the US there is such a culture that's perpetuated of people being wholly responsible for their own actions, and that we see any failings as failings of the individual. Meanwhile drug abuse numbers continue to grow, streets continue to get lined with tents, and people would rather write those things off as personal failings rather than indicators of systemic problems.