[markovs_gun]

Perdue Pharma/The Sacklers went on a huge campaign in the 90s convincing doctors and the general public that pain was bad and worth stopping at any cost and even though they were pushing opioids, I can imagine this also increased the cultural tendency to use NSAIDs as well.

[Mordisquitos]

I agree that Purdue Pharma was probably the most significant factor, maybe enhanced by the relative ease of granular lobbying of private doctors as compared to the challenges it may face in universal healthcare systems. However, I do suspect that the limited rights of most US workers to take sick leave served as one more cultural advantage in favour of Purdue's campaign.

In many countries if a doctor believes you're too sick to work you have a right to take leave until you recover, without risking your job and without expending limited "sick days". In those circumstances the doctor will of course prescribe something for your pain, but as a patient you have no incentive to insist the painkiller is strong enough to allow you to continue working.

[hilbert42]

Right, Purdue Pharma—the sleasebag Sacklers—were unethically pushing OxyContin (oxycodone) but the unethical tactics that Merck adopted in marketing its NSAID Vioxx seems to have been forgotten. Vioxx was withdrawn from the market and Merck paid out billions in law suits.

As I've mentioned elsewhere, the Vioxx scandal is every bit as big as the Purdue one. Check this Wiki (lawsuits): https://en.wikipedia.org/wiki/Rofecoxib

If you've time watch this YouTube video on Merck and the Vioxx scam (if you weren't aware of the facts you'd think you were in Palermo/Mafia territory): https://m.youtube.com/watch?v=K0GrFnOpJoU

[sidewndr46]

Weren't the Perdue Pharma products sold in combination with Acetaminophen?

My assumption was this was always required to get regulatory approval to make abuse have harsher side effects. Liver toxicity of acetaminophen is pretty bad compared opioid abuse from what I understand