Evans et al. (2017) have pointed out how frequently and pervasively nonmedical prescription opioid use is associated with severe pain in young adults, especially young white males. This is a subset of such nonmedical users at tremendous risk of overdose (indeed 1/3 of the study respondents had an overdose event), especially given their concomitant use of benzodiazepines. Avoiding further contributing to the catastrophic rise in overdoses requires access to comprehensive pain care for these young adults. If they were to require opioid therapy, it would have to be in the context of a highly complex and expert variety of such care. If we fail to make it available, we will fail to address the root cause of overdoses for a sizeable subset of nonmedical prescription opioid users.