I think it's due to the whole "drug abuse" hysteria that we've seen in the US for the past 25 years or so.

I've had surgery where the doc was VERY reluctant to medicate, also various fractures with the same story.

Jules has the best advice I've seen yet - shop for a Doc who will provide you with suitable palliative care.

Another idea - strictly "not medically recommended" practice, BTW - is to use the warning about alcohol as a "serving suggestion."

I routinely drank a couple of beers to potentiate the Tylenol 3 when I had my hernia surgery. Flame away, medical types - but it worked for me when nothing else did and I had no other options!!

(The down side is that if you stop breathing as a result, you might have a slight problem - you can "work" the potentiation thing, but you don't want to overdo it!!)

As always, I'm NOT a doctor, and your mileage may vary.

Good luck, be safe...
Hugo