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As a physician:

No, the 'vast majority' do not. I've supervised medical grade opioid administration to more than a few people, both acutely and chronically, and *folks without a pre-existing substance use problem* do not often develop one, especially if it's over the short term. The idea that "I give you an opioid and then BAM I want more!" is highly divergent from my clinical experience.

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As a physician, you should know that using opioids to experience euphoria and pleasure is drastically different from using appropriate doses to combat the effects of pain. It's the euphoria and pleasure that triggers operant conditioning and the accumulation of ΔFosB that occurs in the vast majority of addictions[1]. Only after receptor downregulation does withdrawal avoidance become a factor, but once that occurs, it doubles the strength of the operant conditioning.

Use != Misuse, but use for pleasure is a direct precursor of misuse.

[1] https://en.wikipedia.org/wiki/FOSB?wprov=sfla1

dFosB also accumulates in chronic pain and in some types of acute and inflammatory pain.

The grand-parent comment to which I am replying describes near-instant addiction in the context of an opioid prescribed for pain control.

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