In a recent commentary, it was suggested that that the origins of the opioid crisis involve a complex, intertwined set of factors that allowed “unscrupulous” physicians and pill mills to drive a prescription opioid crisis that subsequently evolved into an illicit opioid overdose one—and that this pathway to opioid use disorder (OUD) exists separately and outside of opioids responsibly prescribed for chronic pain management.1 While it is true that the opioid crisis is one of the most complex public health crises of today’s era—involving comorbid psychiatric and physical conditions, a continually changing drug market landscape, and low rates of treatment accessibility—the authors of this commentary fall into what they are arguing against: an oversimplification of the issue.