Over the last several decades opioid treatment for chronic pain has become increasingly popular. From the sense that chronic pain had previously been undertreated, to drug companies anxious to sell new "designer" opioids, usage has increased several-fold. In its unfortunate history non-specialists were persuaded to prescribe opioids before they could possibly understand the complexity of the treatment. So great were the pressures to prescribe, opioids were prescribed indiscriminately. It became almost impossible to deny opioids without seeming inhumane.

While carefully selected and...