Let us say that we would not have FDA and all drug companies would sell freely what they find profitable. In this option, would we have a bigger or a smaller epidemic of opiates abuse?

Knowing that the government is not involved, citizens would form many monitoring organizations. Doctors prescribing drugs would be more vigilant. People in pain would be more reluctant in taking painkillers. There still would be dishonest producers, distributors and doctors. Thousands of Americans would die due to their abuses of our trust. But I am convinced that it would be many fewer than with the failure of our current system.

We tend to trust blindly FDA. We tend to trust blindly the set of laws that should protect us from abuse. This system failed because the same as without it, some people had been bribed. With the centralized system, very few of them needed to be bribed. Without this system, bad guys could not bribe all the sceptics. In this case, the bad guys would be stopped much earlier.