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So I don't really dispute any of that, but it feels like this conversation is getting a little shifted or circular, I suppose as a consequence of it being with so many people. What I'm really arguing against is ulyssessword's point that "the 'opioid epidemic' is an appropriate reaction to the chronic pain epidemic". I find it pretty hard to buy into, humans have been doing manual labor for millennia, opium has been around for millennia at varying levels of availability, but only now somehow is blue-collar manual labor so strenuous that using opiates to dull the pain is an appropriate response.
It seems more likely to me to be something like the point that sarker and TheDag are making, that the pain is actually a symptom of broader cultural disease, not a natural consequence of manual labor.
Uh, I'm pretty sure that the laboring classes who had access to a lot of drugs have proceeded to do a lot of drugs for all of recorded history. "They drink way too much" is a pretty universal blue collar stereotype, because that's a nearly universally available drug that's priced at blue-collar affordable levels in most societies.
Opium may have existed in 1890, but it wasn't widely available in the US the way it often is now. Booze was the drug of choice for construction workers and miners suffering from nonstop pain; when we decided it was a medical issue doctors of course can't say "have you considered needing some AA?" and so prescribed oxycodone instead. I suspect that the issue will fade with the normalization of medical marijuana.
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