I forgot to add that, this said, things were almost unbelievably bad the last time I was back in the US (2008; I'm living in the UK). I get the impression that the situation is worse there.

Though it didn't help that in the area I'm from, prescribing is under lots of extra DEA scrutiny from the "hillbilly heroin" scapegoating. Which translates to an awful lot of hillbillies in untreated pain. The doctor I ended up seeing had a new policy of not prescribing any opioids whatsoever (really handy when I could hardly walk with my back out, while doing 24/7 nursing!), and my terminally ill mom could not get anything like adequate pain relief until she got hospice care.