Access to naloxone, needle exchanges and medication-assisted treatment for opioid addiction are clearly needed and are widely promoted, BUT these are merely Secondary Prevention approaches. They can reduce harm to individual addicts but do little to stem the tide of new cases of addiction, and they are expensive compared to what is needed most: Primary Prevention. Unfortunately, relatively little attention is being paid to this by pundits and policy-makers. Basically, primary prevention means eliminating the source of the problem: overuse of artificial systemic analgesia with opioids. Progress on this has been marginal for multiple reasons, at the root of which is the failure to appreciate the essential role in tissue health and healing of an intact physiologic pain response (unimpaired nociception + free movement). Until this is corrected, the dual epidemics of chronic joint inflammation/injury/pain and opioid addiction will rage on and on. Ignorance. Sad.