My husband has reflex sympathetic dystrophy (RSD), also known as chronic regional pain syndrome (CRPS) -- probably one of the most painful neurological pain syndromes known. He has an implanted pain pump that delivers morphine directly to his sympathetic nervous system as well as an implanted spinal cord stimulator. Additionally, he is on oral pain meds and neurontin for breakthrough pain. He has always taken the meds as (and almost always less than) prescribed. Doctors have never worried about addiction with him.

Will he have a physical withdrawal if the meds are stopped fully? Oh, heck yes. But the reaction is due more to the pain increasing than the medication. His pain level is so high without pain meds that it would send him into physical shock. We actually had this happen a few years ago. His pain pump ran out (which should never happen but the doctor's office screwed up and miscalculated his refill date) and he didn't hear the alarm (very soft). He did have a serious physical reaction.

Chronic pain syndromes are real. They have to be treated and the whole opioid crisis thing has been particularly difficult for patients like my husband. Fortunately, he already had the pump in place and over 30 years of serious pain control measures on record. But he still has to jump through the bloodwork hoops (which are ridiculously expensive) to pacify the government rules.

He is very careful with his oral pain meds. Never takes more often than prescribed and takes as mild as possible. He has a family history of addiction so he is very wary, but it has never been of issue for him (probably because he is so careful AND his pain is so horribly real).

I rarely take pain meds. I have taken them for things like kidney stones and most recently after some major dental work. But I take them only as prescribed (or less) and only for a few days. My doctors never prescribe more than maybe a week's worth, and I rarely finish a whole prescription.

The people who seem to be abusing pain meds are getting refills after a procedure or injury that doesn't warrant refills (THAT is the doctor's fault) or worse, using other people's meds when their own run out, or even worse, doctor shopping for meds, etc. which is why the FDA has started tracking prescriptions.

If you get pain medications from a doctor, use them as prescribed, don't get them refilled (and if you have to do so, only go back to the doctor who prescribed them so they are aware you are needing more which probably means something else is going on), you are less likely to fall into an abuse/addiction pattern. If you find yourself seeking more, particularly from different doctors or from other friends or family, that's a strong sign you have developed a problem.