Americans use a lot of drugs, even compared to older countries. It's not just the prices. Our national mascot should be a patent medicine salesman.
What baffles and alarms me is the use of opiates for mild to moderate pain, which is completely inappropriate and has obvious consequences (which, I understand, are very visible these days) but is widespread in both the United States and Canada.
It's insidious. The direct-to-consumer advertising on television is the most visible symptom, but pharmaceutical companies spend even more on marketing to clinicians and other paths for shaping the conversation. They lobby public officials directly, they stand up patient advocacy groups, they spin up their own non-profits and research institutes. It's hard to find anyone whose mouth hasn't been stuffed with gold, in ways both obvious and subtle.
The industry has taken a long time to move away from "pain as the fifth vital sign." It's still official policy for the VA, as far as I'm aware, and was disowned by the leading accreditation agency for hospitals only within the past few years.
