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They are still severely under prescribed in nations across the world. To the point that they are not available at all in many countries due to puritanical lobbying. Which means people across the globe are still suffering an absolute horrible fate, despite how easy it is even for a developing country to produce pain medication. The world still hasnt recovered from the last US crusade against pain medication, so i am more then a bit worried about what happens in the US right now. The fact that large parts of the world today have worse pain management options available to their population then what was available in the middle ages should scare you a lot more then some guy having fun with his medication.

People misusing pain medication is a small price to pay to have pain medication available for people who need it. There wont be an optimal solution by pushing down on pharma companies and doctors, it will be quite a lot worse then today.

To put it simply, if you are lobbying to combat the so called "opioid crisis" you should think damn hard about the consequences of your actions. Because if or better when there is another backlash peoples suffering caused by a lack of pain medication will be on your hands.

At least my view from living in Europe is that medical care is at least partly cultural. In the US we put a lot more faith in technology (devices, surgery, etc) than you see elsewhere. Also the the approach of optimization is different. In Sweden when I injured my shoulder, I was given a conversation on over the counter remedies first, and if these were not sufficient would have had a conversation with a physical therapist, and eventually when these fail maybe stronger medicines would have been used. As it was the NSAIDs recommended (which were strong NSAIDs, much stronger than ibuprofen) worked for me.

I don't think it is fair to criticize medical practices across cultures. Every culture has a different view on these and optimizes for different things.

> some guy having fun with his medication.

You don't think that's a bit disingenuous?

We all are making choices in our life. Abusing pain medication is also a choice. If it was problem born only out of lack of information, we wouldnt have this discussion about the necessity of tighter restrictions. You only need restrictions if you want stop people making choices you dont like. Otherwise education would be sufficient.

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