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Guideline Information for Patients

Safer, More Effective Pain Management

Living with chronic pain can be challenging. It is essential that you and your doctor discuss treatment options with all of the risks and benefits carefully considered. Some medications, such as prescription opioids, can help relieve pain in the short term but also come with serious risks and potential complications—and must be prescribed and used carefully.  

The new CDC Guideline for Prescribing Opioids for Chronic Pain helps inform providers’ ability to offer safer, more effective pain management and supports clinical decision making about prescribing opioids.

What are opioids?

As many as 1 in 4 people receiving prescription opioids in a primary care setting struggles with addiction.

Opioids are natural or synthetic chemicals that reduce feelings of pain. Common prescription opioid pain relievers include:

  • Hydrocodone (Vicodin)
  • Oxycodone (OxyContin)
  • Oxymorphone (Opana)
  • Methadone
  • Fentanyl

Are opioids safe?

Prescription opioids can help with some types of pain in the short term but have serious risks. They can be an important part of treatment in some circumstances and can effectively relieve suffering for patients with active cancer or others in hospice or palliative care, but studies are not available to indicate whether opioids control chronic pain well when used long-term. Before taking opioid medication for your chronic pain:

  • Discuss pain treatment options, including ones that do not involve prescription drugs.
  • Tell your doctor about past or current drug and alcohol use.
  • Discuss all of the risks and benefits of taking prescription opioids.

What are the risks from opioids?

Patients taking prescription opioids are at risk for unintentional overdose or death and can become addicted. From 1999 to 2014, more than 165,000 persons died from overdose related to prescription opioids in the United States.1 Up to 1 out of 4 people receiving long-term opioid therapy in a primary care setting struggles with addiction.2,3,4

In addition to the serious risks of addiction and overdose, the use of prescription opioid pain relievers can have a number of side effects, even when taken as directed:
  • Tolerance—meaning you might need to take more of the medication for the same pain relief
  • Physical dependence—meaning you have symptoms of withdrawal when the medication is stopped
  • Increased sensitivity to pain
  • Constipation
  • Nausea, vomiting, and dry mouth
  • Sleepiness and dizziness
  • Confusion
  • Depression
  • Low levels of testosterone that can result in lower sex drive, energy, and strength
  • Itching and sweating

Remember, your doctor is a partner in your pain treatment plan. It’s important to talk about any and all side effects and concerns to make sure you’re getting the safest and most effective care.

What is the new opioid prescribing guideline and how will it affect me?

Photo: doctor speaking with patientCDC developed the new Guideline for Prescribing Opioids for Chronic Pain to help primary care providers make informed prescribing decisions and improve patient care for those who suffer from chronic pain (pain lasting more than 3 months) in outpatient settings. The guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.

If you have chronic pain and are prescribed opioids as part of your treatment, your doctor should monitor you regularly. This might include extra assessments, a pain treatment plan, more frequent office visits, and urine testing. Prescription opioids can be very dangerous if not used properly. Make sure to follow all of your doctor’s recommendations.

If you are prescribed opioids

  • Use them only as instructed by your doctor. Never take opioids in greater amounts or more often than prescribed.
  • Avoid these other drugs while taking this medication:
    • Alcohol
    • Benzodiazepines (such as Xanax and Valium), unless specifically advised by your doctor
    • Muscle relaxants (such as Soma or Flexeril), unless specifically advised by your doctor
    • Hypnotics (such as Ambien or Lunesta), unless specifically advised by your doctor
    • Other prescription opioid pain relievers
  • Work with your doctor to create a plan on how to manage your pain, and consider non-opioid options.
  • Follow up regularly with your doctor.
  • Talk to your doctor about any and all side effects and concerns.
  • Store opioid pain relievers in a safe place and out of reach of others.
    • Help prevent misuse and abuse by not selling or sharing prescription opioid pain relievers. Never use another person's prescription opioids.
    • Find your community drug take-back program or your pharmacy mail-back program to safely dispose of unused prescription opioids pain relievers.

Know your options

Talk to your doctor about ways to manage your pain that don’t involve prescription opioids. Some of these options may actually work better and have fewer risks and side effects. Options may include:

  • Acetaminophen (Tylenol®) or ibuprofen (Advil®)
  • Cognitive behavioral therapy
  • Physical therapy and exercise
  • Medications for depression or for seizures
  • Interventional therapies (injections)

Poison Help 1-800-222-1222Where can I get help?

If you or someone close to you needs help for substance abuse problems, talk to your doctor or call SAMHSA’s National Helpline at 1-800-662-HELP or go to SAMHSA’s SAMHSA’s Behavioral Health Treatment Services Locator.

If you have questions about any medicines, call the U.S. Department of Health and Human Services Poison Help Hotline at 1-800-222-1222.

Tools and resources for patients:

References

  1. CDC WONDER
  2. Banta-Green CJ, Merrill JO, Doyle SR, Boudreau DM, Calsyn DA. Opioid use behaviors, mental health and pain—development of a typology of chronic pain patients. Drug Alcohol Depend 2009;104:34–42.

  3. Boscarino JA, Rukstalis M, Hoffman SN, et al. Risk factors for drug dependence among out-patients on opioid therapy in a large US health-care system. Addiction 2010;105:1776–82.

  4. Fleming MF, Balousek SL, Klessig CL, Mundt MP, Brown DD. Substance use disorders in a primary care sample receiving daily opioid therapy. J Pain 2007;8:573–82.

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