The culture for opioid prescribing has shifted dramatically with the newer generations of physicians very rarely prescribing unless in the very short term as part of significant injury or major surgery.
Outside of cancer related pain, no study has ever demonstrated opioid, including illegally obtained ones, helps chronic pain in any way has significant potential to make the pain worse and a longer term issue by introducing addiction and tolerance to medication.
That being said, I can definitely say that visits that I’ve attempted to intervene on someone on these meds chronically, are usually the most difficult visits and people generally get very manipulative, angry, verbally abusive, and even violent toward my staff. I’ve gotten the threat more than once that goes “If you don’t fill my meds, I’ll just go buy heroine” and I just refuse to play that game anymore. I will do whatever I can to safely get someone off these medicines and onto alternative meds or supplemental treatments, but I drew the line years ago that if someone is willing to break the law and obtain these things illegally despite my efforts, I take no responsibility for that and threatening anything simply doesn’t work.