Opioid dependence is a real thing and many times starts from narcotics received after surgery, emergency room visits etc. Working in the ED, I can clearly see how there is a huge opioid epidemic. Almost 80% of visits to the ED come with a chief complaint of pain somewhere (whether its abdominal, arm, chest pain etc). Many of these patients actually have pain, but some of them are "drug seeking." The challenge is what to do from a provider point of view.
On one end, if you give a drug seeker pain medication, he will just be back for more (with more "pain"). On the other hand, how can you judge who is really in pain and who is not. I have seen many providers who say, ‘oh he’s drug seeking’ and don’t provide anything more than Tylenol for the patient. I have also seen other providers give pain medication to the same patient for the same complain. It is very hard to judge someone and say he’s faking it and he’s not. This is the big challenge. Just because someone keeps coming back for the same thing, doesn’t mean he is faking it. This is especially true with the sickle cell patients.