Elaine, I really can't let some of these assumptions about long term opiate therapy go unchallenged. While everything that you said is true in some cases, it is very one sided.
Many people are able to be maintained for many years, more than ten, on the same dose, once an effective level of pain relief has been reached. The reason for escalating dosages in many cases is the ineffectiveness of the original medication. It is the nature of opiates that you cannot necessarily start out with a dose sufficient for moderate to severe pain but have to work up to it.

I dislike being an apologist for narcotics but I have done a lot of research as I am likely to be on them for the rest of my life. Medical journals, books, and periodicals like practical pain management give examples of long term studies, longevity studies, etc. which show that the stereotypes you mention are not the whole story. Opiates are still the safest and most effective pain relievers we have, with a track record thousands of years old, and it never ceases to amaze me that while many anti-depressants are also addictive, and in the case of Effexor, may never be able to be discontinued, no one makes a peep. It is much easier to discontinue morphine!

I am sure that you do not mean to make it sound as if everyone on these drugs is on them for psychological gratification, but that does come through. I can assure you that as a college student in the 1979-1982 period I know what getting high feels like. I have yet to duplicate that feeling despite the heavy doses available to me. I can, however, make dinner, help my son with his schoolwork, and go for a long car ride.

Rebound pain is much more talked about than actually documented. I even discontinued my morphine for a while when the burning skin symptom started. Unfortunately while my legs hurt much more the burning did not go away. It is just another of the weird things SFN can do. Most of the things I have read about rebound pain either discount it as rare ( articles by pain doctors) or use it as a scare tactic.

If someone's symptoms respond to other treatments, they would be wise to save the heavy hitters for the day they really need them. For some of us who are only getting worse and for whom there is no treatment that day is now. It is unfair to paint with too broad a brush. At 52 I know that this is what the rest of my life will look like, that a wheelchair is in my immediate future, that I go upstairs on my hands and knees now and will not be able to do even that someday. I am grateful for the level of pain relief I have and hopeful that I will be able to stay at this dosage for a long time.