The main issue to me seems to be at the moment a doctor prescribes the initial medication. Should we prevent the doctor from prescribing it? Should we change the guidelines when it can be prescribed? What are those guidelines? What do we do if the patient become addicted? The guidelines you posted don't go into those details.
Read the article about New Hampshire suing OxyContin maker Purdue Pharma. Purdue Pharma spent hundreds of millions of dollars since the 1990s on misleading marketing that has also overstated the benefits of opioids for treating chronic, rather than short-term, pain. Yes, you can use opioids for a few days to treat short-term pain but if you go for more than a few days or weeks, you become addicted–at a much higher rate than Purdue Pharma let on.
Entire graduating classes of medical schools since the 1990's have been told that patients need relief from pain–and I agree, but if the pain lasts more than a short while, then there's other medical problems involved and the opioids are likely masking the problem–or the patient is addicted.
Getting addiction treatment early offers far better outcomes than after a patient is a long time addict, you would agree right? So, shouldn't doctors be taught how to spot signs of addiction? You would think they would be but in general, they aren't unless they specialize in addiction treatment.
As far as a patient's right to pain relief, in terminal cases, I absolutely agree...if somebody has a terminal disease like cancer that causes a lot of pain, hell, give them anything they want including opioids, medical marijuana, alcohol, meditation, massage or anything that eases their last days, weeks or months of life.
But terminal patients aren't the ones with long term opioid addiction that transition to illegal drugs when their doctors finally catch on and quit writing scripts...heck if the doctors could quit over prescribing in the first place or put addicted patients in early treatment we wouldn't be having this conversation...