I'm in the market for a new Primary physician. One of my criteria is that they must be ready, able, and willing to prescribe opiates as needed. I read Gar1eths post above, and know that Tessalon and dextromethorphan are completely ineffective when i have bronchitis. Codeine works, and incredibly well.
I had a hip replacement, and could not explain to the bloody Nurse that I wasn't "escaping" my analgesia; rather, I wasn't getting enough analgesia. I didn't spend half-a-year training in Pain Management, nor doing Acute Pain Management for six years, without learning something.
And if anyone is still prescribing "oxycodone 5 mg with APAP 325 mg," point them to me so I can teach them the error of their ways.
I had a particularly intelligent Orthopedic surgeon, perform my knee replacement. I was on a low-dose opioid analgesic (like oxycodone 5 mg thrice daily) prior to surgery. He told me post operative analgesia would be a problem.
Post-op: 15 mg oxycodone every three hours, was just about right. For like 6 weeks. My Surgeon said he would prescribe as much as needed, along wiht Physical Therapy, for three months, then it was gone.Over. Don't even bother.
And so I was.
Part of the "opioid crisis" is lack of oversight by the prescribing physician. In my Pain Clinic, we paid expecial attention to the patient's opioid consumption and interactions regarding any additional requests for medications. But we saw thirty patients a day.
The "crisis" is one of bureaucracy. It is not inappropriate medicine.