You're not wrong, but addiction is not a certain outcome. Most people who use a substance that can lead to addiction don't become addicted. The question is why can two people, for example, abuse alcohol for a period of their youth, but both don't become addicts?

We need to look at this holistically. Overprescribing is a problem, but we shouldn't be needlessly afraid of these substances. Personally I've been prescribed these medications, I took some and when it stopped hurting I stopped taking them and the bottle sat in my medical cabinet in case I injured myself later. Eventually it expired and I threw it away. It wasn't an issue of will power or anything like that. I just didn't feel the compulsion. I'm the same way with alcohol and other drugs. I enjoy it when appropriate, but I feel no compulsion whatsoever. I, in fact, prefer mental clarity.

But I have people in my life who develop very strong compulsions and become addicted to anything that distracts them from their psychological torments. Reducing access helps, but reducing other circumstances in their life that they may feel the need to numb has to be part of the solution.

> but addiction is not a certain outcome

Not certain but chances are very high with the new class of opioids.

Yep I've seen similar in various countries with a parent. They were prescribed large doses of some opioid pain killers and despite them being aware of the risk of addiction and thus being very careful about dosing (often skipping doses if the pain was tolerable and asking doctors to minimize the dose), in the end they still had a difficult time coming off them. They didn't end up trying to feed that habit from elsewhere, but it was still a lesson in how quickly a dependency can be formed.

I think skipping doses might actually increase the likelihood of addiction.

One of the things I recall that made oxycontin so problematic was Purdue's insistence to prescribe it as a 12-hour dose. There was an article I recall reading on the topic:

https://www.latimes.com/projects/oxycontin-part1/

> Experts said that when there are gaps in the effect of a narcotic like OxyContin, patients can suffer body aches, nausea, anxiety and other symptoms of withdrawal. When the agony is relieved by the next dose, it creates a cycle of pain and euphoria that fosters addiction, they said.

> Peter Przekop, a neuroscientist and physician who oversees the treatment of painkiller addicts at the Betty Ford Center in Rancho Mirage, said that repeated episodes of withdrawal from OxyContin “absolutely” raise the risk that patients will abuse the medication

To me skipping doses is likely to create those repeated episodes of withdrawal which even when minor can end up screwing with the brain's addiction centers. This is why I'd rather take other options that maybe only work for 5-6 hours instead of 12, but don't build this vicious cycle of addiction like oxy does.

Huh, I wasn't aware of that. Will keep it in mind in the future, although hopefully I don't end up needing to do so.

Medication management is a clusterfuck, same with ADHD meds.

Someone people just like to get high; painkillers to H to F seems far fetched but when you are chasing that original euphoria, its a much shorter timeframe than most expect.