This case focuses on the opioid epidemic in the USA from historical and regulatory perspectives. It provides an overview of public health departments in the USA and the public policies and laws that address the opioid crisis with the intention of responding to the ongoing epidemic. The case also provides an overview of the medical use of opioids and a short history of its use in the treatment of pain relief, a description of opioid use disorder, and societal context for the opioid epidemic worldwide and in North America. The involvement of the pharmaceutical industry in the onset of the epidemic is also discussed, including analysis of the role of many contributing parties including Purdue Pharma L.P. (Purdue), the American Pain Society, the Portenoy and Foley Report, and the Centers for Medicare and Medicaid Services.<br><br>This case will introduce students to market failures in the context of public health and enable them to apply their learning to situations with multiple stakeholders but no clear perpetrator, while introducing them to existing US public health policies related to mental health, addiction, and illicit drug use.