March 14, 2018 -- In 2016, opioids were involved in 42,249 deaths, five times higher than 1999. That figure is expected to exceed 60,000 in 2017, based on preliminary death data, according to research organization Altarum and CDC officials.

Scientists at the NIH, the nation's chief medical research agency, are working on solutions for addressing the public health crisis by investigating new and better ways to prevent opioid abuse, to treat opioid use disorders and to manage pain. Francis Collins, MD, director of the NIH talked about the roots of this epidemic, promising research into both addiction and the treatment of pain, and President Donald Trump's budget proposal for 2019. Here is an edited version of the conversation.

WebMD: You have said that the U.S. got itself into this opioid crisis because there was a belief in the medical community that people with pain would not become addicted to opioids. Where did this belief come from?

Collins: It is a little hard to figure out all the origins of that misconception. I would like to say that some significant part of that was done out of concern for people who were suffering from pain and the desire of benevolent physicians to try to help. That led to a sense (by doctors) that we should be more attentive to pain conditions and led to the idea of pain as the 'fifth vital sign.' (The four vital signs are body temperature, pulse rate, rate of breathing and blood pressure.) And there was a belief that these very powerful pain medications would not be addictive for people who were suffering from pain, but only for people who weren't. In retrospect, we can now look back and say there was no real evidence to support that interpretation, and it started us down a very unfortunate path.

WebMD: Why didn't anyone think it would be addictive? Was it because there was no evidence that it was addictive?

Collins: [There] was the notion that long-acting opioids that didn't give you an immediate high were less likely to result in addiction. That turned out not to be true, either.