Sure there’s a difference,. The difference between “idiopathic chronic pain” and “opiate addiction” is whether the person being diagnosed has health insurance, white skin, and access to a CVS as opposed to a stolen stereo and access to a guy on the corner.
You can’t know for sure that the opioids are the cause of his pain. There are tons of situations where pain comes in despite a lack of any clear physical source.
I guess this guy’s brother-in-law could be the first person in history to develop ‘chronic pain’ after multiple back surgeries and not be an opiate addict, but I’m playing the odds here
But, even if they are the cause, so what? If no other treatment helps, and he is able to function on his current dose without getting more, why shouldn’t he just keep taking it?
Why shouldn’t he live his whole life in the thrall of the worst addiction there is? I’ll leave that as an exercise to the reader.
No one is saying addiction isn’t a disease or that there shouldn’t be compassionate treatment for it. But let’s stop pretending that “chronic pain” is something other than addiction for rich white people or that “just live the next 40 years constantly checked out of life on oxy pills, assuming you don’t OD before then” is some kind of answer.