I couldn't find the link, but some years ago I listened to a talk on the Cato Daily Podcast (https://www.cato.org/archives/type/multimedia/category/9390 https:/

I couldn't find the link, but some years ago I listened to a talk on the Cato Daily Podcast (https://www.cato.org/archives/type/multimedia/category/9390 https://www.cato.org/archives/type/multimedia/category/9390) from a doctor, describing his experience with opioids. The doctor said that, having read medical literature, he believed that exponential increases in opioid dosage were an appropriate response. So (exact mathematics aside) if a dose wasn't sufficient for a patient, then you double the dosage. And double it again, and again, and again as necessary. This was not the conventional wisdom, so he was prescribing much much higher doses than was typical. Was this approach to dosing correct? Maybe? It was unclear to me if people eventually reached an appropriate dosage and then held steady. From there of course patients sought him out for their pain management, people who had constant chronic pain, because he was willing to offer a treatment other doctors were not. Eventually there was concern about opioids, and this doctor's very high prescriptions quickly became noticed. He was shut down. Without access to the pain treatment he was willing to provide (and other doctors were not) several of his patients committed suicide. I still don't know what I think about the whole story. What is a manageable amount of pain? Are individuals able to identify the boundary between pain management and... whatever other experience we consider to be an inappropriate use of opioids? Because you could be "addicted" to opioids while only using them for pain management, i.e., only trying to achieve a comfortable existence. If we believe individuals can self-determine the boundary between appropriate and inappropriate use, how then do we trust individuals to report on this? Especially if we believe that addiction makes a person untrustworthy, maybe even to themselves. And how do we rate pain, when for so many cases it is genuinely subjective? Like, we have no way to see what pain a person experiences except for them to tell us, maybe relating it to a more objective experience (like: does this hurt more or less than a bee sting?) (Does everyone even have shared experiences that cover the necessary range of pain?) I don't really buy Cato's relatively extreme perspective on this (that we should let people do whatever they feel is right, and that all the harm is from restrictions that lead people to dangerous substitutes). But there's clearly some hard philosophical questions here to consider.