The vast majority of those deaths are, and have been for quite some time, mostly attributable to illicit fentanyl and other street drugs, or polypharmacy.  Calling spinal injections, something I had over twenty years ago, advanced therapy is like calling the Dodge Dart the epitome of a modern automobile.  As for the opiod-hysterical tone of the article:  BMJ Jan 2018 500,000 surgical patients given opiods post-op between 2006-2013: all of PT6% showed signs of misuse. Point 6%!!!  Nora Volkow, Director NIDA  March 2016 in NEJM article states that the majority of opiod naive patients turned addict are people with a predisposition, and that it is a minority among those to who it will happen.  Most patients with a legitimate prescription (per SAMHSA 80% of non-medical users have pills never prescribed for them) who became addicted had a prior history of some type substance abuse and or mental health issue, gamed their doctor, abused the directions thinking foolishly they could return to normal activity quicker or that they shouldn't feel any little twinges of pain, or got the script at a pill mill type operation.  Please stop with the ridiculous hysteria that only serves to harm responsible pain patients while doing nothing for the real problem, which has moved past prescription pills being the cheap readily available flavor of the day. It's now heroin, fentanyl, and the returns of coke and a p2p meth that's 1/4 the price it was 15 yrs back.