Opioid addiction is a huge problem on the mainland in suburban and rural areas-- often among white teenagers--and this problem is a major concern among Trump supporters. The high cost of opioids and restrictions on its availability has led to increasing heroin use as a cheaper and more available drug than prescription opioids. You can become quickly addicted to opioids-- as soon as a single 5 day prescribed course-- using prescribed opioids for two or three weeks can create an almost impossible to shake addiction.  I am currently on the mainland and a physician neighbor told me that within three or four block radius of where we live, two high school students were dealing heroin to pay for their opioid addiction (in one case started by prescription for a sports injury, and in the other case by using unused meds--over prescribed-- from a parent). Deaths occur from mild doses because it suppresses the breathing reflex when asleep.