You know what drug has the lowest NNT (Number Needed to Treat) for chronic pain? Pregabalin so saying ALL non-narcotic analgesics have a 'fraction of the effectiveness of the weakest opioids' is clearly and demonstrably false, some are even more effective. Treating chronic pain is quite different than treated a busted fibula of course though. I could give far more examples of demonstrably effective alternatives to controlled substances for different indications but I suspect it wouldn't matter anyway if you don't care about that and you're going just going to believe what you do because it fits the rationalization.
Pregabalin is also indicated for a specific type of pain, forms at least a moderate physical dependance and is, going off the big thread in Other Drugs, at least mildly ''recreational'' itself. Not to mention it comes with a host of side effects (, and many of these side effects aren't well understood, especially for a such a new drug, which I personally find worrying). There's also a lot of sketchiness in it's history as far as development, obtaining approval, marketing, off-label prescription etc. goes.
On the flip side, you have opiates, which relieve pain almost universally, have been used to do so since the dawn of civilization and as such are well understood, along with being well tolerated. If you're unable to work or sleep because of pain, which one would you want to leave the doctor's office with? There's plenty of time to look into long term, hopefully more sustainable and more permanent treatments (and it requires plenty of time), but to leave the person in pain and unable to function while they wait for something which has a small chance of maybe helping somewhat is nothing short of cruelty and negligence.
My point wasn't that benzos are the most recreational drug ever but that doctor's have good reason to be cautious with them and many who have been around a while are all too familiar with the fallout of prescribing them too cavalierly. Standard protocols don't always call for them to be used as a first-line treatment and much of the recent professional literature of late calls on doctors to try less problematic (but still demonstrably) effective alternatives first and if those fail, then consider benzos but a history if illicit use is always going to make doctors weary of prescribing controlled medications. It's interesting to me how on BL, SSRI's, bupirone, hydroxyzine, atomoxetine, etc. NEVER, EVER work but in real life, the people I come into contact with have experience that match the clinical efficacy of the drug much more closely.
Firstly, someone who's experiencing debilitating symptoms doesn't have time to cycle through SSRI's and assorted other meds on the off chance that they may provide some benefit which outweighs the side effects. People want benzos as the first line of treatment because benzos work immediately and reliably, providing minimal disruption to their life. Then while the benzos manage their anxiety, they have time to experiment with the more dubious, long term treatments. Doing it in the opposite order will only result in the complete disruption of the individuals life, as their functioning crumbles while they wait a month for X med to work, only to find out, whoops, it doesn't, let's try Y med, spend months going through this whole harrowing process while their symptoms get worse, then as likely as not, they end up on benzos at one stage or another anyway, or they get desperate and disillusioned enough to find a new doctor or bypass the medical system alltogether. This process is horrible enough in a country with decent healthcare, I'd hate to see what it's like in the US, where the majority of bluelighters come from.
As for the latter point, have you considered that if an individual found their anxiety adequately treated by other medication, they wouldn't be on bluelight talking about benzos in the first place? They'd be out enjoying their anxiety free, benzo free existence.
Treatment protocols are pretty straightforward as well and when someone demonstrates a history of non-sanctioned use (such as pissing positive for morphine), of course their first line is going to be one a drug without the potential for abuse and this was an ER doc! He shouldn't be the one managing these problems anyway and was merely giving the OP something he felt could be beneficial and felt comfortable prescribing given the context. If a doctor finds out a patient uses morphine recreationally, would it be responsible to say, "here, have some xanax to add to that so we can make sure you stop breathing."
If we're going to go into the specifics of the OP's case, then it's a bit more complicated than that. From the doctors point of view, it's easy, but not exactly reasonable or professional, to assume that the individual has morphine in their system because they're trying to get high. And to be fair, that is what it sounds like happened in this particular case, but there are plenty of other reasons someone can test positive for morphine - all it takes is a headache and a friend offering you some panadeine forte (or T3's as I think they're called in the States) and bam, you have morphine in your system.
I won't argue that it doesn't seems pretty cut and dry in the OP's case, going off what he's said, but I'm just pointing out that there's a broader spectrum to the issue at large. Not everyone who has opiates in their system is a filthy, drug seeking junkie trying to work the system, not everyone who goes through their benzo script early is trying to get some kind of ''high,'' and again, if these non-abusive medications worked nearly as well as the ''abusive'' ones, then people wouldn't be here on bluelight talking about their abusive counterparts, they'd be out enjoying life. I've seen more than one person find a treatment that works for their problems, or even a cure, and abandon this place to move on. Unfortunately is usually takes them years and a lot of time, money and suffering. The fact that someone is here (discussing these kind of drugs - the whole hullucinogen/MDMA/etc. situation is another issue) suggests that there's still something in need of treatment.
Another thing I have learned reading BL for many, many years is that BLers look for a pill to treat everything. Addicts want the easy way out, they don't want to work for it or endure the discomfort of the type of non-pharmaceutical therapeutic interventions that have the best success at treating anxiety; they just want to find which band aid is the most effective at making sure they don't have to think about/deal with the problem. CBT and other techniques (especially when individualized to both the person and the problem) are hands down the best way to treat these problems but over the years I've seen hundreds of posts where people complained that their doctors wouldn't prescribe them benzodiazepines as first line, at all or any more but yet to see one that complains a they they didn't have access to a good psych professional for cognitive behavioral theraphy; they just want to be given some pills to chill them out and that's a big part of it for mant around here
That's a load of nonsense. Firstly, you characterize the entire bluelight population as 'addicts,' which is unfair and untrue. Secondly, you suggest that they intentionally avoid seeking out non-pharmaceutical methods of treatment, when you have absolutely no idea that this is true (unless you've done an extensive survey, in which case I'd love to see it).
Bluelight is a forum for talking about drugs and how to reduce the harm from the consumption of those drugs. When someone asks a question about treating anxiety with benzos, I don't start rambling on about my daily meditation routine, or my weekly psychotherapy, because that isn't what they asked about and this isn't the place for that conversation (although I do try to make a point of recommending they seek out complementary modes of treatment if it seems relevant). There are section of bluelight where those conversations are more common (Dark Side - Sober Living - Healthy Living, etc), but you're not going to find that conversation somewhere like Basic Drug Discussion because it's blatantly off topic.
