Where it is different, however, is when alternative means are suggested but the patient is obsessed ONLY with the drug.
That is precisely where it is not different.
I would become angry very quickly if some quack tried to take away painkillers that were controlling my pain very well in favour of deep breathing exercises and a couple sessions in a hot tub.
Luckily I’m a DO so I can get what I need, when I need it, despite the NHS.
We don’t become hysterical when people are “dependent” on beta-blockers, SSRI’s, or any number of drugs the sudden withdrawal of which can cause nasty rebound syndromes.
Its only painkillers because, my god, they might make people feel good as well as controlling their pain, and we just can’t have that.
Short acting benzo’s are viewed this way by the NHS.
So what if ativan actually works for people with chronic panic disorder, let’s put ‘em on SSRI’s or beta-blockers (drugs that can have many difficult to live with side effects than and are less effective) because someone, somewhere, might be getting doped up on ‘em.
What is most pathetic about all this is the fact that most of the “life destroying” side effects that accompany opiate dependence can be traced directly to the practice of making the drugs difficult to obtain rather than the dependence itself.
As for all this talk of obsessions, the obsession with denying that opiate based drugs are usually the most effective remedy for chronic pain is bizarre and unhealthy in itself.
As a physician you should know that the dependence on an SSRI is not the same type as that of an addiction. That is so blatantly a broad-brushed statement that, for a physician, it calls your motivations into question.
Good clinical practice is not to “make people feel good”, as you imply. Relieving acute pain with opiates or acute anxiety with benzos are legitimate treatment goals. When the disorders become chronic, the addictive quality of those medications countervail that indication.