Among the new guard, there was a sense that the opioid crisis had now taken on such catastrophic proportions that it was no longer a viable option (if it ever had been) to keep selling opioids without so much as a gesture of conciliation. At this point, more than 165,000 Americans had lost their lives to prescription opioid abuse since 1999. Overdoses had now surpassed car accidents to become the leading cause of preventable death in America.