The handful of well-intentioned docs are the exception, not the rule.
I wouldn’t be so quick to judge the intentions of doctors who do over-prescribe. Consider this scenario:
You are a doctor. Your patient comes in with severe pain from a herniated disc caused by an injury at work. None of the ordinary painkillers or muscle relaxants you prescribe are working and they keep returning to your office to complain about constant pain. You know that opioids will be extremely effective at reducing or eliminating their pain but you also know that these drugs cause addiction. You explain this to your patient and they are adamant: they are 100% willing to risk becoming a drug addict if it means they can escape their severe chronic pain.
What do you do?
Personally, I find this dilemma so troubling that I would not want to be a doctor because of it. I have other reasons for not taking that career path but even if it were the only reason it would be enough to stop me. I don’t think it’s at all obvious that you can just ignore a patient in severe pain and say “I’m sorry, I won’t prescribe this legal drug which will alleviate your pain.”
There is no spoon.