prospects for a chronic narcotics patient.

As an ER nurse, I think I have a skewed view of pain management. (long term). I was hopiing for some advice from some of you who understand long term pain management.


A good friend has chronic pain issues resulting from MVA trauma. He is high functioning, manages a division with a multi-million dollar budget. Other than a 30 year hx of cigarette and marijuana use, he is healthy. He is physically active, appropriate body weight, etc.

His pain is reasonably managed with Percocet- I am not sure how much. It allows him to function both physically and professionally. He is well aware of the hazards of chronic narcotics, but can't function without them.

As far as I know, the source of the pain is not correctable. (At least not with traditional western medicine. He hasn't looked at other options.) He receives excellent medical care, and apparently, there is no fix.

My question: What are his prospects? Can people continue to function on a high level with ever increasing amounts of narcotics? In the ER, what I see are pain control failures. Also, I take a medication list from every patient, and have never seen a high functioning individual who is on chronic, high dose narcotics.

Any thoughts?