Beyond Opioids: New Guidelines Offer Safest Ways to Control Pain


In the past, if you had minor surgery or an injury your doctor would often prescribe an opioid pain killer to ease your discomfort. But, that is less likely under new guidelines for physicians.

The Centers for Disease Control & Prevention (CDC) recently released the first federal opioid prescription guidelines. They are written for primary care providers, but patients should know about them, too, says pain management specialist Richard Rosenquist, MD.

“The goal is to help physicians prescribe opioids in a rational fashion,” he says. “We have an incredible number of people dying from overdoses, and prescriptions must be more aligned with the medication’s proper use.”

CDC’s guideline process highlights U.S. opioid abuse epidemic

An article in the Journal of the American Medical Association on the guidelines says more than 165,000 people died from opioid overdoses between 1999 and 2014. In 2013, roughly 1.9 million people abused their prescriptions.

Another startling statistic: Overall, the United States — which makes up about 5 percent of the world’s population — uses 80 percent of all prescription opioids.

And, opioids are often over-prescribed, Dr. Rosenquist says. Doctors either write prescriptions for too many pills or they offer opioids when there are better choices. The new guidelines, he says, will help them identify how and when a patient really needs an opioid.

A considered approach to managing pain

Here are changes you may see in your doctor’s approach. According to the CDC’s suggestions for managing pain, your doctor should:

Opioid side effects you should know about

Dr. Rosenquist says, opioids can help control pain, but higher doses do not necessarily make them work better. And, opioid use has serious risks.

If you take them long-term, they sometimes cause:

Large daily doses of opioids — 200 mg morphine equivalents or more — may put your risk of death at 1-in-32, Dr. Rosenquist says.

Combining opioids with a drug such as Valium® boosts your risk of death between four and 10 times.

Ultimately, Dr. Rosenquist says, the guidelines should help doctors use opioids in a more rational and appropriate way and help head off problems before they start.

“People have begun to turn the faucet back on the availability of opioids,” he says. “The goal is not to eliminate their use altogether, but rather to use them in a more effective fashion and to reduce the incidence of prescription drug abuse and death.”