A 3-step analgesic ladder was introduced in 1986 and needs change. Surgical interventions could reduce opioid use and motivate expansion of current pain management approaches.
AMA J Ethics. 2020;22(8):E695-701. doi:
10.1001/amajethics.2020.695.
One of the many doors money and power often open gives access to opioids where they would otherwise be withheld without strict oversight and management. Elvis Presley provides perhaps the most famous example of unmanaged access to drugs.