From the string of spinal surgeries my wife has endured ( 8 surgeries ), the scarring in her spine is massive; and it puts constant pressure on the nerve routes. It’s call adhesive aracnoiditis. An expert on the condition told me: All the pain of terminal cancer, without the benefit of death.
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In some cases, opioids are the only answer.
Sometimes it just boils down to quality of life.
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All but your last are suggestions that make sense.
On the last, I don’t want any gov’t agency dictating the relationship between legitimate pain patients and doctors.
Now, for doctors selling scripts to fuel the illicit drug trade I’d be all in with you for those types of penalties.
Most of the addiction problems stem from abuse of use or taking the meds longer than recommended.
In coal country the miners work through the pain by taking these pain killers prescribed by company doctors. Some have been taking them for years just to get by.
Some people can become addicted just by normal use. Each person has their own tolerance.