http://brainblogger.com/2015/01/30/opioids-for-chronic-pain-an-interview-with-dr-webster-pain-guru/
Opioids for Chronic Pain – An Interview with Dr. Webster, Pain Guru
To develop an addiction, a person must be exposed to the drug. Avoiding the use of opioids whenever possible decreases exposure. Decreasing exposure reduces the chance for the disease of addiction to be expressed…
If an opioid is to be prescribed, an assessment for risk factors should be performed followed by close monitoring for aberrant behavior. Addiction can be triggered with the first dose or develop after prolonged exposure. People with a “loaded” genome may express an addiction earlier than those who are spared many of the genetic risks. People who develop an addiction later may have less of a genetic vulnerability, but the stress associated with chronic pain can tip toward destructive use behaviors. Using urine drug testing and prescription drug monitoring is essential to detecting non-adherence, which could be a sign of addiction.
For more on how to prevent opioid addiction see my book, Avoiding Opioid Abuse While Managing Pain…
I personally believe that the FDA should set a deadline for when all ER formulations must meet a minimum standard of abuse-deterrent properties to remain on the market. If this were to occur, the cost of ER formulations would likely increase, but this may be a reasonable trade-off for potentially safer products. Of course, this move will not eliminate all dangers; people can still overdose if they take multiple pills of an abuse-deterrent formulation…
It is important that prescribers have access to interstate data sharing because patients can easily move from one area to another if they intend to deceive the prescriber. In some cases, physicians can access data from prescription monitoring programs in surrounding states by contacting those states, but this takes more time and work than is desirable. For years there has been a push for a nationally centralized database of prescriptions. However, funding has been lacking to make that happen…
Pain Guru or Addiction Guru?
All Things Chronic 
Another “guru” pushing the fiction that the relatively low risk of “addiction” and associated harms exceeds the guarantee of torture and a destroyed life for those who could benefit from opiates. The absurdity of it all is that opiate addiction is usually managed the same way as pain is: with opioid maintenance, We don’t want to put you on opiate maintenance because you might become addicted and need to be on opiate maintenance. We would rather see you tortured to death while asking for money to research a non-addicting “cure” we will conveniently never find because there will be no excuse for us to monopolize it like with opioids.
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i am right there with payne’s comment. on the money.
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