Here's why:

1) Most ordinary people don't want to abuse drugs or allow them to interfere with their lives. While some heavy painkillers can feel pleasant for a while, in my experience most people don't enjoy feeling "zonked" for long periods of time, and also don't like the side effects (nausea, constipation, etc.) I'm sure we've all had "the good stuff" after dental or medical surgery. In my experience, most people don't like to keep using drugs they don't need. Most grown-ups know that this is serious stuff and don't fool around with it for fun.

2) In my very limited (but eye-opening) experience working in Social Services, it seemed to me that the people who actively seek narcotic drugs, either from legal or illegal sources, have serious emotional issues—ie. deep shame/pain from extreme abuse, neglect, psychological/physical damage. Without these particular circumstances, a lot of people would not seek out the numbing/euphoric effects of narcotic drugs for "recreational" or escapist use.

3) Some people really do need to take stronger drugs than usual to deal with their situation, and they may need them for as long as their pain lasts. People do develop a tolerance which means that a "normal" dose for one person would be an extremely high—possibly life threatening—dose for another person. This an unfortunate aspect of how pain medication works.

4) If the doctor really is a good doctor, if he/she has integrity and is attentive to the situation, I don't see why the LW shouldn't trust him. Weaning someone off certain drugs after long periods of use can take time, but it does not have to be a medical emergency or an addiction tragedy. Not all doctors are pill-pushers; in fact in my experience the good ones tend to err on the side of caution and avoid prescribing "the big guns" unless absolutely necessary.

5) Unfortunatlely, there are some people who get a twisted sense of self-righteousness from insisting that other people suffer through extreme pain (ie. during childbirth, dental surgery, cancer treatment, etc.) while they stand smugly by, denying them relief. They honestly believe that enduring (and making others endure) intense suffering is more "moral" than taking "dangerous" pain medications. Some people really can't imagine the torture that someone else may be experiencing. If narcotic or other drugs—as imperfect as they are—appropriately prescribed and carefully controlled, ease severe pain, then this is what must be done. I think it is up to the sufferer to decide how much they need to have a decent quality of life.

6) Not all awful conditions are fixable—we have a hard time accepting this. Some illnesses are rare and unfamiliar to modern people, and can be especially horrible, because they last for so long and cause such tremdous suffering. We are lucky we have the medications we have here in the West. There are many parts of the world where any kind of pain medication is non-existent, and people endure amputations, surgery and disfiguring/life-threatening injury without the slightest relief.

I just don't believe that all narcotic use is necessarily bad; for some it is the only way to make life bearable.

is that there is a pretty predictable mood / emotion trajectory that accompanies specific lengths of time away from home.

There are a reasons beyond calendar convenience why standard vacation packages are commonly sold in 5-day, 7-day, 14-day, 21-day lengths. Many people cannot handle total leisure (lack of purpose) for more than a specific amount of time. 4 and 5 weeks away can start to feel like a really long time, depending on the reasons for the trip.

If all goes well, most people get to a destination and settle in, they start to unwind, they do what they want to do, they enjoy themselves and the place . . . and then there comes a moment where it feels right to start wrapping it up, and look forward to heading back home. Most people get to the point where they are saturated with the experience, hopefully satisfied, and looking forward to returning to our real life.

Now, obviously, this is not one-size-fits-all. Every person has different reasons and needs for their travels, but I would bet that EVERYONE has experienced that point where a trip has just gone on a bit too long. We go "OK, I've had enough. Time to get back home." For some people this can be after day 3, for others after a month, or whatever. But I do believe that for most people, there is a "right" time for the vacation to be over.

After a certain point you feel as if you should make efforts to resume a semblance of normal life (participating, contributing, working, living), either "THERE" or "BACK HOME", and most times BACK HOME is the winner. (This is why the Foreign Service rotates their staff with regular frequency—people can start to "take root" in the new place, and start becoming a "local" with corresponding attitudes sympathies, given too much time.)

This was surprising to me when I first heard it, but I believe it is true.

It seems to me that the LW's wife is at the point in her adventure where she is still enjoying all the thrills of being in a new place, and is (rightfully) savouring what it has to offer. Missing her home life is the furthest thing from her mind at this early stage—as it would be for almost anyone.

Over the course of a 5 week trip, there will be ups and downs, highs and lows, recreation and business—and I would guess that around week 2 or 3 the LW's wife will start yearning for some of the comforts of home.

There are many benefits to travel, not the least of which is that it can make you appreciate what you have.

If this is a good relationship at it's core (and if they get this insecurity/privacy issue resolved), the LW's wife will miss her hubby and home in due time, and will start to look forward to resuming her real life.