You could actually argue that someone selling heroin to an addict is doing something consensual, where both parties know what they're getting into. You can't say the same of opioid manufacturers, who intentionally buried vital info and muddied the waters of public perception.
The intention was to make money, knowing that millions of people would be harmed. Who cares if the method was "just marketing"?
Yes, ineffective and dangerous.
> "Opioids are ineffective in the treatment of chronic pain, and the dangerous risks associated with using and abusing opioids have led to America's most deadly drug epidemic."
-- National Safety Council
> "Ibuprofen Plus Acetaminophen Equals Opioid Plus Acetaminophen for Acute Severe Extremity Pain"
-- Govt-funded trial at UVA
> "Ibuprofen, acetaminophen more effective than opioids in treating dental pain"
-- Case Western Reserve University
> "In summary, reliable conclusions about the effectiveness of long-term opioid therapy for chronic pain are not possible due to the paucity of research to date. Accumulating evidence supports the increased risk for serious harms associated with long-term opioid therapy, including overdose, opioid abuse, fractures, myocardial infarction, and markers of sexual dysfunction; for some harms, the risk seems to be dose-dependent."
And after that, you're welcome to look at examples where pharma execs admitted to misleading doctors about both safety and efficacy.
Your other two sources are just subsets of pain and ignores many other uses of opioids.
If there's no evidence something is effective, it should be considered ineffective. I've found sources that say there's incomplete evidence and sources that say opioids aren't significantly better than placebo, but no unbiased reviewer says that they're more effective than OTC and generic painkillers.