Opioid use grabs headlines when important celebrities overdose. Prince is sadly the most recent. But the problem is persistent and pervasive. The marginally good news is that the number of opioid prescriptions written started to decline last year. Overdose deaths, however, continued to rise. Also in the news have been lawsuits against pharmaceutical companies and distributors for helping to create the astounding oversupply of opioids, but the root causes go deeper. Physicians and their patients, medical policy makers and licensing boards, pharma companies and pharmacies all have played roles. And all must work together to stem the opioid epidemic and achieve the fundamental objectives of reducing addiction and deaths.