Can I check how you're using "chronic"?

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)."