We have read with interest the debate surrounding opioid use in the USA and related deaths. We also welcomed the different perspectives of Gerard A Kalkman and colleagues,1 concluding that universal health care and addiction care in Europe contributes greatly to preventing an opioid epidemic of US proportions. If we agree with many points, we respectfully disagree that this prevention is homogeneously helping to prevent such a crisis development. The authors mentioned only the opioid crisis i...