The legacy patients who (justifiably) fear abandonment are some of the most vulnerable in this discussion. They were prescribed opioids aggressively, and in some cases inappropriately, which has resulted in dependence. Now, if they are forcibly tapered or abandoned by physicians, they face truly hellish withdrawal—a form of suffering that could completely understandably drive someone to take their pain management into their own hands by accessing the black market. Physicians must juggle their dual obligations not to prescribe recklessly, while also not allowing their patients to suffer
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