Tunrs out karma may have bitten me for my sarcasm....my godfather just called me saying his daughter is addicted due to a doc disopensing oxyc and xanax and more. Apparently part of his h and p was to ask how much she thought she needed.
Doctors don't make addicts. Addiction is complex biopsychosocial disease werein the primary problem lies with the addict and their maladaptive use of the substance. The "4 C's", denial, deterioration, etc.
Doctors can be complicit in the maintenance and worsening of addiction, either by poor training, ignorance, neglect or malice. But they don't make someone addicted - that happens as the patient loses control over their use of the drug. Failure to recognize and treat the addiction is the doctor's problem.
I've had patients who have shown themselves to be addicts, and when confronted/approached about it, used the defense mechanism "You made me into an addict!" No, you chose to take more medication than I prescribed, and/or to take it for reasons other than pain. I'm trying to help you, before to provide pain releif, now to treat a new diagnosis.
I got a patient into rehab once(one of the few who ever went). 6 months later, not having seen me since rehab, she OD'd and died. Her sister reported me, her other pain med-prescribing docs, her PCP and her pharmacy to the state boards. My records proved me innocent and the case was dropped against me with no action. 2 of the other docs surrendered their licenses and another was sanctioned. The pharmacy and pharmacist, I believe were also found to be not at fault.
The sister also asked for a copy of the records as the next-of-kin. I assume she took them to a lawyer, but no case was ever brought against me for it. Then, in a newspaper report after her sister's funeral, "She places the blame for her sister's death squarely on the shoulders of the doctors who were feeding her sister pain pills." Not the boyfriend who went to jail shortly before that for drug dealing. Not the patient who chose how many pills to take that day. Musta been the doctors. The fact that she (the pt) was getting drugs from at least 4 different docs (at least prior to rehab) didn't matter to her (the sister).
That one case went a really long way toward my current approach to treating chronic pain patients with opioids.