I made a list of drugs for pain relief as that was what was asked for. There are very few situations (arguably none) in which all drugs are practical.

Expecting any drug to replace opioid is very unrealistic at this time and as I have commented on, dealing with chronic pains should be multidisciplinary and not entirely reliant on just pharmaceutical therapy for the most effective way of tackling the issue.

One of the largest barriers is tackling patient (and indeed many healthcare provider) mindsets and psychologies. Opioid rotation is not a long term solution. Opioid reduction is the main aim but requires a huge turnaround of thinking/effort/money.

Prevention is better than cure generally. Stopping the opioid problem in a patient beforenit deveoops into a massive chronic issue is far better than trying to sort it when they aren on 160mg BD and it's five years down the line. One situation that can be worked on is the acute pain apatient who comes to hospital (e.g. After a trauma). If the analgesia is effectively tackled then, with the likes of the medications I have mentioned, and they get discharged without the need for ever escalating opioid prescriptions, how is that a bad thing? If you disagree and you think they should just get ever escalating doses of single agents then, again, that's your opinion.

As of yet there is no panacea and I doubt there ever will be. Based on your name I'm guessing that you are somehow involved in the pharmaceutical industry? If this is the case then no doubt you are aware of how difficult it is to create a drug that has decent efficacy, acceptable tolerance and safety profile and a cost efficient process of manufacturing, distribution and marketing.

I never said