Alcohol actually is relevant--and note what happened when we were stupid and tried banning it. Opiates used at a sustained level are actually not that harmful-

Alcohol actually is relevant--and note what happened when we were stupid and tried banning it. Opiates used at a sustained level are actually not that harmful--the danger comes from those who are deliberately seeking the extremes (things like crushing the time-release pills and snorting them) and from the lack of quality control of the illegal marketplace. We don't see the chronic pain patients keeling over left and right from ODs--except when we try to deny them the relief and drive them to the illegal market or to suicide. If the cause of their pain doesn't otherwise mess them up they can often lead reasonably normal lives. We also have a problem with confusing habituation with addiction. A patient who needs controlled substances will likely habituate and be in a bad way if they're denied but that doesn't mean they are addicts--you can seek the relief the drugs bring without seeking the drugs themselves. If the underlying problem is resolved you taper them off and it's not an issue. Part of the opioid crisis was the doctors being deceived into thinking the tapering wasn't needed. The CDC has finally realized that cutting them too quickly is medically bad--but the system is still geared to persecute drug seekers and catches too many innocents in the loop. Woe to the patient that loses the doc that has been handling the drugs! (And it's not always because they were going to a pill mill. Doctors are human, they retire, they get sick, they die. And the DEA likes to pressure pain management docs into retirement.)