The opioid epidemic in the United States has been declared a public health emergency, with opioid overdose deaths tragically claiming hundreds of lives daily. While this issue is faced across the globe, the United States has the highest rates of opioid use and associated overdose deaths in the world. There are several interrelated explanations for the present-day opioid epidemic. Initiatives to aggressively treat pain, in tandem with persuasive marketing of highly effective analgesic pharmaceuticals, have led to a unimodel approach for managing pain centered solely around prescription opioid analgesics. In the last two decades, unprecedented access to prescription opioids has contributed to a nationwide epidemic of drug-related mortality. Interventions to mitigate this problem coming from the government, pharmaceutical companies, and physicians have caused reflexive surges in overdose deaths related to heroin and illicit synthetic opioids, which are now cheaper and more readily available. Overdose deaths continue to spread at unprecedented rates across the country. The severity of this problem is enormous and has proven difficult to resolve. Without an answer, the crisis is predicted to accelerate. A better understanding of how this problem evolved is imperative to identifying a viable solution.