[wayn3]

People take painkillers because they can't afford surgery.

Say you have a messed up disk in your spine. Surgery is tens of thousands of dollars. Getting a prescription for opioids from a primary care physician is a bit cheaper.

You don't see doctors in europe routinely prescribing hard pain killers because they try to fix the problem instead.

Healthcare in america is set up in such a way that hospitals just bill whatever and then have the lawyers argue over whats reasonable. That kinda works when youre part of the medicare system and their lawyers represent your side, but when youre on your own, you're suddenly in hospital recovering from major surgery, facing bankruptcy and have to hire a lawyer to tell the hospital to suck it.

So you just take the painkillers and hope for the best.

[brandonmenc]

> Say you have a messed up disk in your spine. Surgery is tens of thousands of dollars.

There are situations where risks from surgery are potentially worse than the (yes, possibly misinformed) side effects of painkillers.

Is there any data on this? Anecdotally, I know a few people who are either living with pain or taking medication because surgery is too risky.

[wayn3]

I'm not saying that everything has to be surgically repaired. Whatever the surgeons decide to do I'm cool with 99.9% of the time.

Its just that there are people who "should" have surgery who "can't" have it because money.

Another issue is that just because a doctor advises you to take opioids doesn't mean that you're not abusing them. Doctors tell you to do all kinds of things that are bad for you because they are the lesser evil. The prime example being chemotherapy.

The primary use-case of morphine-like substances is to treat acute pain. Taking any kind of opioid for prolonged periods of time leads to systemic adaptation and you end up an "addict".

Is there data on this? Probably. Depends on what you want data for. The fact that america is under-insured when it comes to healthcare is well-established fact.

I don't buy "people take opioids because their lives are lame" - because its bullshit. There are drugs that are way easier to acquire that provide a lot more "fun". You don't start on heroin and then switch to vicodin, either. A heroin addiction is treated with methadone.

If you want a really clean "feel awesome" high, you want a benzodiazepine like Lorazepam. I had a prescription for that once. Popping one of those pills, you smile from ear to ear within seconds and experience pure bliss. If you intentionally try to have negative thoughts, you just laugh harder because it feels so ridiculous. If you wanted to "trick" a doctor into prescribing those, faking the necessary symptoms is really simple.

The drug industry has a pretty good grasp on how to engineer drugs to do one specific thing really well without causing a bunch of secondary effects. Modern painkillers are good at dealing with pain, without turning people into loonies. But opioids are opioids and if you take them indefinitely, you mess with brain chemistry.

[hammock]

People also take painkillers to recover from surgery...That is how many folks get hooked, and in some cases, eventually switch to heroin (because they can't afford the pills off-script at black market prices)

[wayn3]

You mean there's a non-trivial number of patients who are prescribed opioids to essentially self-medicate at home because keeping them in the hospital until they're recovered is "too expensive" - who are then told to deal with their addiction themselves because no doctor felt the need to actually guide them through responsibly using their drugs?

Who are THEN told that they just can't get drugs anymore because now they're just filthy addicts. That's actually impressive. For a glorious nation like the united states of america. Borderline malice.