One extremely important fact in drug policy, which is known widely to medical professionals but seems to be absent from most public discussion - opioids are not bad for you.
This is why you get sent home with a box of them after surgery. You're also sent home with a load of health warnings about the pain killers. All of which centre on paracetamol, which is much more dangerous.
The bad thing about opioids is that they're addictive and the withdrawl is extremely bad.
(1/N)

To the extent in which drugs policy is evidence based, most modern drug policy is based on studies of traumatised rats in laboratory conditions. Then there's a puritanical component. Methadone has worse withdrawl than heroin. If the health risk of opioids is primarily addiction, then switching them to a drug that is worse for this does not seem to be in their best interests.
There did exist a different policy before Thatcher and we can compare the results of each.
(2/N)

In the old days, people did sometimes get addicted to pain killers during medical treatment or sometimes while living abroad. When this happened, they told their GP what was going on and she referred them to an NHS treatment centre.
That centre gave them opioids. They came in every day, took their opium while a nurse made sure they were ok and then went about their day.
Patients did well. There was virtually no illegal opioid trade.
(3/N)

Then Thatcher decided to treat the issue as a moral one rather than a medical one and we switched to the protocol in use today.
For evidence of how well that works, I can just look out my window and see my neighbours and community subject to appalling misery.
Government distributed opioids would destroy most of the illegal trade. It would be safe for users. It would make people less vulnerable and allow them greater control of their finances. It would save money.

In moral terms, the cost of treating drugs as a police matter is astronomical in terms of effects on people's lives.
To put this in the terms of neoliberal capitalism, it's expensive in terms of state resources required, depressed property values, lost income, anti-social behaviour, etc.

There is no evidence to suggest that prohibition of opioids has better outcomes in terms of cost to taxpayers, outcome for addicts, or public health.

(5/N)