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You're premise is likely incorrect. As a non-American there is a very good chance there is an opiate available over the counter with no prescription in the form of codine.

https://www.oecd.org/health/health-systems/opioids.htm

It's not an American problem, its a "First World" problem.

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But usually in small amounts, in small containers at high prices. And mixed with far more toxic ingredients.

It doesn’t stop everyone. But for those it doesn’t, they risk succumbing to the paracetamol or ibuprofen before the codeine.

They could separate them, but I don’t think it’s common.

Also, poppies are stupid easy to grow, but nobody seems to bother recreationally, suggesting that ease of access was never a root cause.

That graph puts things in perspective. It turns out that I'm living in a country where opioids are not very available compared to other nations. Here you can't even get cough syrup with codeine in it without a prescription and even then doctors won't generally prescribe that.

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