It's bad but not terrible in Europe. That is, addicts can get straight diamorphine (aka heroin) in many countries, often locked behind failing methadone therapy but at least it's there, and we generally don't have issues like in the US where there's a straight oxycodone to black market pipeline. Also, socialised healthcare and everything.

If opioid addiction was left completely to the medical profession we'd have much much better results, the best treatment is tapering flanked by psycho-social treatment. Tapering means: Diamorphine addiction gets treated by diamorphine, in lower and lower doses, at a pace the patients can tolerate. The German term is very appropriate, "ausschleichen", "to sneak out". When addicts don't have to worry about getting their dose they start to function again in a social sense, can hold a job, their overall situation improves, and with that the reason why they drowned their sorrows in the first place. Even if they happen to be too far gone to really get the curve you still get improved lives for the patients and lower costs to society because diamorphine is dirt cheap per dose (if not bought on the black market) and you get rid of all the drug-related crime.

Here in Germany heroin is starting to get laced with fentanyl prompting drug consumption rooms (for people not in treatment) to offer tests and the consumers by and large aren't clueless, but even if you have a laced dose you don't want to take, if it's the only available dose it's going to get shot up. What are you going to tell people, as a social worker? "Let's wait for a doctor's appointment to get you methadone"? Not going to happen. Only thing they can do is watch carefully and already have the Naloxone in their hand.

What's stopping us from providing proper therapy is, more or less, moralising. "Giving the junkies their fix". The kicker is the actual fix for junkies in the end is not the drug, but the ability to live a decent life. Gazillions of US soldiers were hooked to morphine in Vietnam, many doctors were shit-scared what would happen once they came back. Nothing happened: Figures that when you take a person out of hellish conditions, they lose interest in escaping those hellish conditions. And now that I've said that, let me tell you the actual truth: It's moralising and capitalism as that shit is the almost sole reason why people in western countries have lives inhuman enough to resort to those kinds of escapes in the first place.

But without the war on drugs, how are all our capitalist oligarchy's masquerading as democracies supposed to criminalise and persecute the filthy proles?