I don't disagree there are bad actors. Dissolving Purdue (I thought they were dissolved, not just fined?) is great. Bad actors should be punished. And yes, criminalizing medical issue such as addiction is terrible. All of these are fairly obvious, which is why I didn't spell them out.

As I'm sure you know, many cases of mental illness are triggered by some sort of precipitating event.

I don't believe for a minute the fact that someone gave those addicts an opioid pill was the actual trigger. Instead it was something that happened way before that: some emotional trauma, PTSD, disadvantaged background, chronic illness, no life/career prospects, war, despair, etc, etc, so many stressors this life can bless you with. The Big Bad Pill is just what the addicts came across and realized it helped them feel okay for a moment, that's all it is.

E.g. a war veteran ends up getting PTSD and becomes an addict(let's assume he has no chronic pain). Aren't the circumstances around his life that led him to enlist and then develop PTSD are the much more relevant trigger? Barring that event, would they even begin using in the first place?

Who gave them that precipitating event? Other humans did.

The ugly truth is that the cause of this all is simply us, humans stressing other humans. Like other primates, we are intelligent enough to the point it takes very little effort to provide for our basic needs, and so we spend the rest of our time engaging in social status games at the expense of others.

Most people who use opioids do not actually become addicted. Those who used heroin in Vietnam, most of them stopped after they returned and circumstances changed from war to normality: https://pubmed.ncbi.nlm.nih.gov/12873239/

"After their return, most of the men who had used heroin in Vietnam used it very occasionally or not at all."

"Possible post-Vietnam correlates of heroin injection were no job or school enrolment, alcohol problems, depression, absent or transient marriage, association with illicit drug users and other Vietnam veterans."

The real root cause is that humans are nothing but selfish machiavellian apes. We all are about me-me-me-me-me, and dig just a bit deeper, most are just as predatory and sociopathic as Purdue/Sacklers/whatever, just not as capable at getting their way.

We just look away and walk past the addicts in meatspace. We are no saints, and the real cause of most human suffering is not some processed alkaloid - it's other humans.

Not some pharma company or some evil billionaire clan that capitalized on this, I'm sure they contributed. There would be nothing to capitalize on or sell, if it weren't for humans psychologically injuring other humans for fun and profit.

Personally, it seems to me that we can recognize and accept a physical disability/injury much more readily than emotional/psychological one. Same goes for inflicting injuries: attempts to fracture someone's limb, a grave physical injury, seem too repulsive to even think about, and hopefully bystanders will attempt to rescue the victim should anyone ever try to do this to anyone. Harassment, bullying, hazing, belittling someone "just for laughs" on the other hand? All too often, others are more than happy to join in on the "fun" and even will gleefully laugh at the actual victim.

Of course, nobody likes to think of themselves in that way, much too unpleasant, and so we point our collective fingers elsewhere. It's always "them", and never "us".

I can only hope that one day we will evolve to finally dish out just as harsh punishment for psychological harm as we do for bodily harm, and hold each other accountable for it.