It would be really interesting to do a "UBI"-like study where a select group of chronic pain-managed patents are given full control of their prescribed drug and

It would be really interesting to do a "UBI"-like study where a select group of chronic pain-managed patents are given full control of their prescribed drug and dose for ~6 months and study if they have worse outcomes than a control group under normal pain management guidelines. One could make the argument that insufficient dosage would increase the chance of the patient seeking drugs outside of the pharmaceutical system. How does the magnitude of the risk of using impure black market drugs compare to the risk of overprescription? Fentanyl cuts are extremely dangerous. Would the average pain-managed patient choose to increase their dose perpetually, or do they reach a plateau? What percentage of patients would have their lives ruined by carte blanche prescriptions? 80% would certainly justify our current regime, but if it's only ~5%, perhaps those 5% already have identifiable confounding risks that could be screened out. Perhaps those 5% would seek drugs on the black market anyways, and thus giving them access to a clean source would be a legitimate harm reduction intervention. Similarly, I wonder if anyone has ever studied giving prescription opiates to heroin users. It seems like if they could get ~80% of their normal dose legally and without hassle, some might voluntarily choose to stop purchasing from the black market. Heck, I'd imagine many would tolerate quite a bit of hassle, could probably get them to discuss their long term plan for treatment with a health profession before getting each refill. "Do you intend to take opiates forever? Is there anything I can do to help you taper your dose? No? well here's your refill, lets talk again in a couple weeks."