[mapt]

All it takes is the standard opioid pain prescription. That's getting high. Opioids get you high. That's what's necessary for pain relief: Altered neurological states in which pain coming in from the nervous system doesn't have such a strong effect on the conscious mind. It's that simple. Deal with it.

Drugs have effects. Usage doesn't cross some threshold dose and instantly become abuse.

[encoderer]

Oh, I disagree. There is most certainly a difference between therapeutic use for pain reduction, and the euphoric response normally associated with an opiate high. Most people using opiates on-label are not getting high from them. Even if they do the first couple times they take them, that passes.

[daodedickinson]

I definitely got stratospheric on my prescribed dose of one single Ambien pill (couldn't recognize myself in a mirror, saw kaleidoscopic visions, 2d videos became 3d portals into other dimensions). Absolutely some people could get high on one opiate pill. I understand your skepticism, but I'd like to assure you there is tremendous metabolic diversity.

[encoderer]

I didn't say anything about one pill not being enough to get you high. Also, that's not even the question I addressed. The GP said "That's what's necessary for pain relief." -- which is an overstatement.

[pessimizer]

It also passes for people who take enormous amounts with no regard to the label, and had no pain. So what's the difference?

[billmalarky]

Painkillers are incredibly effective at stopping pain before the point at which most would describe the person as "high."

It's not euphoria from a high that blocks the pain, the medication really does work as intended.

It's just also incredibly habit forming and dangerous.

[mapt]

"Painkillers" describes wildly different chemicals, many of which have no euphoric effect whatsoever. We're not talking about "painkillers", we're talking about opiate/opioid narcotics - derivatives or synthetic reproductions of chemicals created in the opium poppy, which are chosen for their efficacy in crossing the bloody-brain barrier and altering our perception of pain (and everything else), via the mu opioid receptors.

These chemicals stimulate receptors in the brain which are part of natural feedback cycles in which part of our brain synthesizes similar chemicals and feeds them to other parts of our brain to nudge conscious thought in a beneficial direction (learning, eating, running, fighting, mating). The broad class of opioid receptors appears to be central to how the vertebrate brain works.

Natural behavioral reinforcement, pain relief, intense euphoric highs: Same receptors, same effect, same mechanism, somewhat different quantity. Injured people given vicodin often describe "Not caring about the pain". Because they're high - at least, a little bit.