Not all abusers of prescription medications are illegally obtaining them. A large amount of people are prescribed pain pills in a completely legitimate way. You may have been in a car accident and suffered serious disk misplacement or fell off a ladder and broke your femur (obviously just examples of legitimate reasons people may need pain medication). Being prescribed prescription pain medications is a very serious matter that needs to be explained in detail by the prescribing doctor.
In this day and age, co-pays are high and many people without insurance have to lay out a lot of money for a doctors visit. Many patients expect to receive some sort of medication for whatever ailment they have. Paying top dollar for the time of a physician doesn't seem like enough to most. Many want to receive some sort of drug to legitimize the co-pay and visit cost. You would most likely be very upset being told to go home and take a couple of aspirin. This puts doctors in a rough predicament as well. If they want to keep their practice successful, they normally treat every illness with a prescription drug. If they do not dispense prescriptions, they may lose patients.
When it comes to prescribing pain medications, it isn't as simple as people may think. If you were to think about it from a doctors point of view, pain isn't something that can be easily measured. For example when someone has strep throat, it can be tested. If the test turns out positive, the patient can be given medications to kill the infection. Pain is not so cut and dry. If the patient has been in a serious car accident for example and complains years later about their back pain but the doctor see's nothing wrong with them via their MRI, it puts them in a tough situation. They have to trust the patient is in serious enough pain that pain management is the best option for them to help live a normal life. Also, how can a doctor tell if someone has a high tolerance for pain or an extreme low tolerance for pain? Again, there is no way to measure pain so it's hard for the doctors to know the truth.
People who have serious pain and need pain management to be comfortable get used to taking strong painkillers. In fact, there are some opiate based painkillers for people who have a high tolerance. Oxycontin makes some large dose medications with the warning: "OxyContin 60 mg and 80 mg Tablets, or a single dose greater than 40 mg, ARE FOR USE IN OPIOID-TOLERANT PATIENTS ONLY. A single dose greater than 40 mg, or total daily doses greater than 80 mg, may cause fatal respiratory depression when administered to patients who are not tolerant to the respiratory depressant effects of opioids".
People on high doses get used to having the pills around and using them. Many people who are prescribed opiates may find themselves taking a little more as their tolerance builds. They may find that they don't have enough at the end of the month. It is highly frowned upon to call a doctor and ask for an early refill for narcotic medication. Most doctors will not even think twice about refilling you early and it puts you at risk of being dropped as a patient for abusing your medication.
Everyone, no matter what your situation is, either legal or illegal who ingest prescription medications need to be educated on the seriousness of them. They should only be ingested by the individual that it is prescribed for and only the exact dosage prescribed by a Medical Doctor.