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People who recreationally used prescription opiates, or people who got hooked following a doctor's pain management directions?
The ones who got hooked listening to a doc are a small minority, but the ones who started off recreationally using prescription opiates is a vast majority
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I've responded to more opiate related overdoses than I can think of. In my experience, you are correct.
The vast majority get hooked on it culturally. Their friends party, they start with weed, they do xanax and other benzos at parties, progress to oxys and percs. It goes downhill from there as those are the people they hang out with, thats what they do when they hang out.
Eventually pill shopping gets expensive and they start off snorting heroin. When the high isn't good enough there, they progress to shooting it.
Many people have addictive personalities and cannot handle it. Many people have zero desire to change. I've seen people OD in the morning, get treated and released, and OD later that day again.