The United States stands alone among developed nations in both healthcare spending and the devastating scope of its opioid epidemic. Despite investing more in healthcare than any other developed country in the world, America has significantly poorer health outcomes across a variety of conditions. These disparities are particularly stark for opioid misuse, addiction, and overdose. Prior to the 1990s, the United States had conservative opioid prescribing practices, similar to those of other nations, but shifts in approaches to pain management, drug potency, and aggressive pharmaceutical marketing fundamentally reshaped standards of care for opioid use in the United States. This chapter explores how these changes contributed to global disparities in opioid consumption and adverse effects. Germany, Japan, and several Nordic countries have implemented safer and more effective approaches to opioid prescribing, addiction treatment, and social services. Despite having aging populations with high pain management needs, these countries have avoided the public health catastrophe seen in the United States through tighter regulatory controls, universal healthcare coverage for nonopioid treatments, and integrated primary-care models for addiction treatment. Understanding these differences in approaches, particularly as they relate to family-centered care, offers valuable lessons for gaining control of the crisis in the United States.