I also think they are highly skeptical of someone asking for a specific opiate formulation, even when they initiate the prescription (ie, you have an obvious injury and they prescribe an opiate). It's highly ironic that they're so worried about addiction they're willing to risk serious liver toxicity.
This is exactly it. For every other condition, patients are encouraged to research their condition and its treatments on their own, and to have an informed discussion with their doctor about treatment options. But not for pain. Anyone with an even modest knowledge of painkillers is instantly labelled a drug-seeker. Ask for a painkiller by name, and the doctor looks at you like you're sitting there with a needle and spoon yelling 'GIMME GIMME DOPE'. And the more you justify why you want something, the worse it is. Doesn't matter how valid your research is, only junkies know that much. And the fact that you might have a clear need doesn't matter. Because if you WANT opiates, you're a drug-seeker, and drug-seekers should be left in pain rather than give them what they want.
That message has been drilled into doctors heads with the DEA leading the push. It's the DEA and drug warrior bureaucrats that define how pain is treated, not doctors. They know that no matter how thorough and professional their care is, they're one junkie OD away from an investigation and jail. Pain management specialists that actually prescribe should be hailed as heroes. Mine used to have the DEA come in, shut down the clinic, and start seizing files at least once every 6 months. And this is a caring professional who is not even close to a pill mill.