What do you suggest be given to people with chronic pain which can't be managed with lower powered pain killers, say people with cancer induced pain?
You added "which can't be managed with lower powered pain killers" -- that step often isn't tried in the US. Doctors and patients are leaping direct to large quantities of opioids.
I'd prefer it if doctors followed the RCoA guidance: https://www.rcoa.ac.uk/faculty-of-pain-medicine/opioids-awar...
"2. A small proportion of people may obtain good pain relief with opioids in the long-term if the dose can be kept low and especially if their use is intermittent (however it is difficult to identify these people at the point of opioid initiation)."
Their pain is not manageable with lower pain killers. I am thankful we have opoids to prescribe, which is making significant improvement to their quality of life.
Cancer pain is not long term pain, cancer pain is short term pain (or acute pain). I've never argued against using opioids for cancer patients or for end of life treatment.
If you take a look at /r/ChronicPain/, you'll find lots of people who have been unfairly affected in exactly this way, some even becoming suicidal because of it.