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I think when you need it you need it quickly because if the pain starts to get out of hand the pills will no longer have any effect. Is it so hard to not take them if you don't need them?

For me, no. But judging by the numbers in the opiate crisis it is for a lot of people.

They have substantial resale value, if you know the right people.

When I got my wisdom teeth surgically removed, the pain was quite bad and I was glad to have something stronger than over the counter. My prescription was only for 1 week. When it ran out, I still had some pain not fully controlled by over the counter pain meds.

Well you were pretty lucky then. I've had pain for weeks after a surgical extraction that was hardly touched by 800mg ibuprofen. It depends a lot on how well it heals, IIRC. And other considerations like whether incisions were required.

I wonder if this has changed since then though. I had surgery on my shoulder a couple of years ago, and had a one week prescription for opioids, then it was as much Tylenol as I could eat but nothing stronger.