Why are opioid medications prescribed in large quantities and high frequency when there is little or no proven efficacy for their therapeutic value? Why are opioids the most commonly prescribed medication in the United States for the past decades when the adverse consequences continue to grow and mount? Why does the medical profession continue to prescribe opioids medications that result in increased pain and increased disability? Specifically, why do physicians continue to prescribe opioid medications despite widespread psychiatric morbidity and mortality? Prescription opioid addiction with its loss of control over use is the short answer.