Ah so the one thing that makes me hesitate to say “You should just prescribe people painkillers when they ask for them” isn’t even true!

Exactly. I’ll even grant that there’s a place for rehabs to deny people drugs and even to force people to get clean against their will. I’m not gonna say “No addiction isn’t real and we should fully let addicts make their own choices no matter how destructive.” But hospitals and other doctors when that’s not the main issue at hand can fuck all the way off.

I think this both on a fundamental moral ground of “why do you get to make that choice for them?” but also for logistical reasons. Because of this disgusting behavior by doctors, patients are afraid of being seen as “drug seeking” even if they aren’t addicts, and will lie about pain and drugs to make sure they aren’t denied.

I have a weird genetic thing that means some oral opioids don’t work for me. I don’t have enough of whatever enzyme turns the precursor molecules in the pill into the actual active painkiller. When I had appendicitis it was so frustrating trying to tell the doctors “the new painkillers you gave me aren’t working, this hurts really fucking bad, you have to give me more dilaudid” without them just looking at me like a junkie. Motherfuckers one of my organs is exploding! Give me the heroin!