Well all that must fuel the problem. When I broke my ankle years ago I don't think the doc would have just kept giving me pain meds over and over. Also with my kidney stones, after my last surgery and all was clear, if I had kept calling in pain, the doc would have believed me because he knows me.. BUT.. He would have immediately checked to see if something else was still going on that was missed and probably give me one prescription, but if he found nothing, he would send me to another specialist.
Also I had two ER visits with the stones and my primary care knew and they got records of my surgeries also, the doctor called to check on me for each visit and surgery.
Maybe that is more closely followed here because I am in a larger city and there is a network for the hospitals and the doctors.
I believe that a part of the legislation that enabled the Ohio pill mill shut down had to do with enabling the sharing of prescriptions filled across entities. Small town pharmacies have done this informally for years--they'll just call around if they suspect that someone is getting too many scripts from too many doctors filled all around town. One of the articles said that the local pharmacies were not about taking scripts from their local pill mill--they already knew what was up. folks would have to take them somewhere where they were not known.
But I think mrssmith is right, a lot depends on the doc. Some really believe that they can handle it--as in "don't worry, I won't let you get addicted." Others just don't care or don't want to be bothered--thinking that some patients will jut get their fix elsewhere. Probably some fall into internal biases--thinking that Mr. So and So who is a professional businessman is not the "type" who gets hooked. Glad the DEA is becoming more active in monitoring. But longterm I think docs are going to need more training in the whole area of pain/addiction.