Although they've been used for 6,000 years, the role of opiates in pain management is much debated today. The role of opioid therapy in the treatment of noncancer pain has been very controversial due to the limited number of clinical trials validating this approach and the understandable concerns of doctors who worry about causing more harm than good.
Physicians also have to worry about regulatory oversight by law enforcement officials.
Many doctors and even patients fear that the patient will become addicted to the medication. However physical dependence is not the same as addiction. Those in severe pain many times take it just to be able to function. Unlike an addict, the typical pain patient experiences little or no euphoria from narcotics. Because the effectiveness of pain medication varies greatly from person to person, a patient's need for a high dose is not necessarily a sign of addiction.