Steve's post makes clear that pain management needs to be very individualized.

In most parts of the USA, good pain clinics have long waiting lists and bad pain clinics are pill factories.

And most Primary Care practices are not trained or equipped to treat even acute pain, and decline to prescribe opioids at all out of fear and the hassle when some one is an addict.

I think I am probably not the only person on Mudcat who did a lot of drugs when young. Fortunately, and probably just because of genetic factors, I never developed an addiction to opioids. I never thought it was fun to feel nauseous or to actually puke. After my accident last fall I was on IV morphine for several days, then on oral opioids for about two weeks post surgery on a regular schedule while in the nursing home for rehab, then a prn dosage regimen. After about a week of the original introduction of opioids I did not need medication to counteract the nausea. After I got home I took a low dose at night when the pain was sufficient to keep me from sleeping for about another week, then stopped all together with no problem because I did not need them anymore. I also have a high tolerance for chronic moderate pain. That is probably also genetic combined with social learning or maybe a stoic personality. I have low tolerance for severe, acute pain and am grateful for the opioids during that time when the acute pain was otherwise intolerable.

I have clients and a few family members with medical conditions thst require long-term opioid pain medications who manage them quite well and without addiction, though would definitely need taper schedule to come off of them because of physical dependence. I also have family members and clients who are or have been addicted.