Oregon doctors and Medical Examiners veer from excessively permissive to excessively restrictive and back in about 20- year cycles.
Currently, we are just a little behind Washington in reining in the rather sloppy habits that prescribers have developed over the past 15 years -- abetted by "pain clinics" and pharmaceutical companies who have been pushing narcotics as more or less thesolution to chronic pain.
Years ago, UW medical school had a superb behavioral pain management program -- but in the early 90's it was eclipsed by narcotics pushers (starting in the Oregon Legislature), and because that sort of thing is expensive and labor intensive -- and requires some buy-in and personal work by patients -- it fell away.
Then the "pain clinics" stopped prescribing the narcotics they recommended, and pushed that task downhill on the "PCP" -- while they confined themselves to lucrative injection techniques and implants (for well-insured patients only, of course).
I'm pretty fed up with the whole thing.
I don't see that "modern" medicine is a great deal better at dealing with chronic pain (say from MVA or logging accidents or neurosurgical back surgery disasters) than we dinosaurs were in the 1970's