"...the problem is with impure products and people misusing / abusing them."

That second part "people misusing/abusing them" is a lot bigger than you're letting on. People can get hooked on opiates easily - a quick trip to Wikipedia turns up: "Long-term opioid use occurs in about 4% of people following their use for trauma or surgery-related pain" [1]. That's a pretty big knock-on effect! If you're prescribed opiates you're rolling the dice, and if you have the right mix of brain chemistry and genetics, you might be screwed.

[1] https://pubmed.ncbi.nlm.nih.gov/30063596/

I do not disagree with that.

> if you have the right mix of brain chemistry and genetics, you might be screwed.

Right. I experience no euphoria whatsoever from any opiates (in any dose)[1]. Blessing or a curse? I personally call it a blessing because I have an addictive personality so I would get hooked up on it too. It works for my pain and my depression & anxiety, and for that I am grateful, all while not causing euphoria, all it seems to do is just mood stabilization, i.e. I am less likely to be emotionally volatile.

The constipation side-effect can really be frustrating though, but thankfully I can manage it through diet and skipping doses.

[1] It possibly has to do with my neuro{biology,chemistry} and my brain lesions but who knows. Psychiatric medications never affected me the way they typically affect others and I have gone through _a lot_. It might be genetic, metabolic (as well), I have no clue.

I had an opiate after surgery once and the constipation was so bad, it was worse than the pain it was supposed to be treating. I switched to Aleve instead, which was both better at pain management and had fewer side effects.

When I had my wisdom teeth out, they gave me percocet (oxycodone + tylenol). "Take one every 4-6 hours." I split the pills in half and took one just as the pain was starting to come back, generally right after 2 hours. It worked great. Then after several days the pain started coming back in my knees and other joints. Wait... I don't generally have joint pain. I guess that's withdrawal from developing a tolerance, aka addiction. I quickly ramped down and stopped using them shortly thereafter.

Of course it would be tempting to wax poetic about how I just needed to use my willpower to stop, and so can anyone else - just-world-fallacy while singing my own praises. But it's more honest to admit that while things worked out fine that time, control can be quite illusory. I wouldn't hesitate to use opiates again for extreme pain, but I sure would set up some social accountability systems beforehand.