How would you know who suffers more on average?
The cases I've mostly heard about seemed to be that people hot addicted to opioids and the only way to keep it going was to break the law. That eventually got them in trouble. For some drugs it does seem like the government trying to protect you from the drugs do more harm than what the drugs themselves do. Are opioids among them?
As far as I remember, only 10% of people who ever used heroin get addicted to it. But that still leaves 10% at a very high risk, because of their neurochemistry and life circumstances.
So I don't think ALL drugs should be legal.
A recent article which contextualises the work is here https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109763/
Obviously it’s lossy to reduce something with this much complexity down to a single dimension but it’s still a helpful tool nonetheless.
> people with chronic pain.
Chronic refers to the length of time the pain exists, it doesn't refer to severity.
Here's what the Royal College of Anaesthetists says about opioids
https://fpm.ac.uk/opioids-aware
> Key Messages
> 1. Opioids are very good analgesics for acute pain and for pain at the end of life but there is little evidence that they are helpful for long term pain.
> 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).
> 3. The risk of harm increases substantially at doses above an oral morphine equivalent of 120mg/day, but there is no increased benefit: tapering or stopping high dose opioids needs careful planning and collaboration.
> 4. If a patient has pain that remains severe despite opioid treatment it means they are not working and should be stopped, even if no other treatment is available.
> 5. Chronic pain is very complex and if patients have refractory and disabling symptoms, particularly if they are on high opioid doses, a very detailed assessment of the many emotional influences on their pain experience is essential.
Especially as it is prescribed in the US, where drugs get preferred instead of other interventions. "Back pain? Opioids. No PT, no losing weight, just opioids. No, not even NSAIDS, just go for opioids"
Remember that some drug companies pushed for their medication to be in 12h regimens which increased their dependency potential, as opposed to a shorter interval preferred by doctors?
As a personal experience, opioids don't seem to work much for me on many types of pain.
For chronic cases, I think chronic makes a lot of sense.
Pain helps you get moving. Opioid's don't. Too much pain is debilitating. Surely we can find a formula here (a very very large one).
Cannabis never removes all the pain. I think that's the main feature here.