Personally, opioids - although creating a form of "blissful apathy" - allow me to function at a much higher level than normal, and I find myself highly motivated while in the "here and now" while on opioids. I use very low doses for a slight but extremely profound alteration of my mood, and also for the relief of chronic physical pain.
I think it has a lot to do with level of dose, of course "nodding out" is going to make people lazy and consumed by the high. Judging from my low dose experiences, it is extremely powerful stuff. I have never once nodded out though, I have no desire to use opioids for that purpose and I never will.
I think they can be highly effective medications if they are not abused.
When I take opiods, there are no physical effects to be noted apart from the total relief of the agony of my years of debilitating spinal nerve pain that cannot be dealt with in any other way.
I have various mental problems exacerbated by recreational drug use. Cannabis abuse ruined a decade of my life and left me with a panic disorder after the withdrawal. It really amped up my social anxiety to a whole new world of panic. Back then, I was pointlessly addicted to an idiotic, retarded high that completely set me off course in life and that I had developed unbearable psychological obsession and dependency with, and a horrible physical dependency via appetite suppression. The habitual of cannabis was for me, pointless. I fiended it way too hard, and no matter how much I was smoking it was in no way constructive whatsoever. It made me lazy and anxious. If I wasn't that way before I got high, it would just zap my energy. But I was still addicted somehow, it never made sense.
Psychedelics do not work for me - although I am spiritually inclined, I do not like having my consciousness altered because it's almost always unconstructive in my case and I consider it dangerous to the brain personally, I'm not the most stable guy, I'd much rather read the Tibetan Book of the Dead and meditate than take a hit of acid which again just sets me off course. I got nothing out of those. Stimulants cause me too much anxiety, even coffee.
I do not find that a low dose of opioids is numbing to my brain at all. It numbs my physical agony, but I warmly welcome that. All my mental problems are still there, it's not like I'm all high and pretending that I'm living in some dreamworld, like with weed how everything just melted away. I am still completely myself, in no way am I delusional, and in no way do I lack control over myself. I am able to handle my problems, I am able to control my emotions. I am happier and more confident, it is quite uplifting. I have a better grip on feelings such as powerful lust, anger, jealousy, frustration, and other negative emotions. The emotions are not being blocked out, I am still experiencing them. It's just that I have a new perspective on them. I am transcending them, and much better able to direct my energy accordingly. I also find that it is mentally stimulating - I'm not one for caffeinated beverages, but my brain works really hard when I'm on opioids - and I actually get a little anxious from it, but I love to study and challenge my brain while on this class of drugs. It is the opposite of laziness, lethargic feelings for me.
I would hardly call it getting high. I would call it medicating all of my life issues that are bringing me down, so that I can be the person I want to be, which has nothing to do with being a drug addict - my normal self, the pursuit of my career path and all my hobbies and interests, which sadly isn't possible without drug use anymore since I wrecked myself through abusing cannabis for a decade. I think I have finally found what I was looking for in the world of drugs, this stuff is right up my ally. I've been at it for months, and there has been no increase in tolerance, and I have not once considered smoking or using a needle. That just seems silly to me, like someone trying to abuse the medication and aiming for the overpowering experience of the drug itself. I have very little cravings for them, and no physical dependency since I am using such low amounts.
You cannot generalize the users of any one class of drugs. The majority function just fine on cannabis. However, that drug ruined a decade of my life and I had the obsession of a crackhead and a physical dependency of a junkie.
For those with mental and physiological ailments, who are not in it to get a rush or a high, I believe that opioids could be highly effective in improving ones quality of life.