If you want a clear explanation of just how much of an outlier the US is in prescribing the powerful drugs that led to the opioid epidemic, consider this statistic given by Stanford drug policy expert Keith Humphreys last week (emphasis mine):
The biggest misconception is that the US is normal in how it handles prescription opioids. So let’s compare ourselves to another country. Japan, for example. Older population than us; you would think more aches and pains. Universal access to health care, so more opportunities to prescribe.
So consider the amount of standard daily doses of opioids consumed in Japan. And then double it. And then double it again. And then double it again. And then double it again. And then double it a fifth time. That would make Japan No. 2 in the world, behind the United States.
Every other developed country does at least as good or as poor a job as we do managing pain — while not using opioids at anywhere near the same level.