Todd --
Chowder good at Charlies Chowder House.
I blame the media and the drug companies for our current narcotics mess -- they play on suffering (and therefore, gullible) patients desires for relief beyond what is possible to provide.
I have essentially been forced on some occasions to prescribe and "manage" megadoses of narcotics by pain specialists who wouldn't consult unless I agreed to continue prescribing after they were done sucking as much money as they could from insurance with their "procedures", then dropping them like hot potatoes.
At least there is beginning to be an intelligent conversation about this in our Coordinated Care Organization (the Oregon version of the Federal "Accountable Care Organization"