Patients’ Frequently Asked Questions

• Acute pain is pain that usually lasts less than 1 month and has a known cause, like an injury or surgery. It normally gets better as your body heals.
• Subacute pain is pain that lasts longer than 1 month but not more than 3 months.
• Chronic pain is pain that lasts 3 months or more and can be caused by a disease or condition, injury, medical treatment, inflammation, or even an unknown reason. Sometimes acute or subacute that is not effectively managed becomes chronic pain.

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

• Hydrocodone (e.g., Vicodin®, Norco®)
• Oxycodone (e.g., OxyContin®, Percocet®)
• Morphine (e.g., MS Contin®, Kadian®)
• Codeine
• Methadone
• Fentanyl

Prescription opioids can be used to treat pain, but there is very limited evidence that they are effective for long-term use. If you’re prescribed an opioid, the best approach is to try the lowest possible dose in the smallest quantity. Opioids should only be used for as long as necessary. Generally, for acute pain (pain lasting less than one month), opioids are rarely needed for more than 7 days and often for 3 days or less.

Before taking opioid medication for pain:

• Set treatment goals with your clinician for pain and function in your daily life.
• Talk to your doctor about pain treatment options, including ones that do not involve prescription opioids.
• Discuss the risks and benefits of opioid therapy.
• Talk openly with your doctor to make sure you’re getting care that is safe, effective, and right for you.
• Tell your doctor about your medical history and if you or anyone in your family has a history of substance use disorder (SUD).

Anyone who takes prescription opioids can become addicted to them. You may also develop tolerance—meaning that over time you might need higher doses to relieve your pain, putting you at higher risk for a potentially fatal overdose. You can also develop physical dependence—meaning you have withdrawal symptoms when the medication is stopped.

To help reduce your risk:

• Never take prescription opioids in greater amounts or more often than prescribed.
• Always let your doctor know about any side effects or concerns you have about using opioids.
• Avoid taking opioids with alcohol and other substances or medications. It is very dangerous to combine opioids with other drugs, especially those that cause drowsiness, such as:
  • Benzodiazepines (such as Xanax® and Valium®)
  • Muscle relaxants (such as Soma® or Flexeril®)
  • Sleep aids (such as Ambien® or Lunesta®)
  • Other prescription opioids
• Do not share or sell your prescription opioids.
• Store prescription opioids in a secure place, out of reach of others (including children, family, friends, and visitors).
• Dispose of unused prescription opioids at the end of your treatment. Find your community drug take-back program or your pharmacy mail-back program, or flush them down the toilet following guidance from the Drug Disposal: FDA’s Flush List for Certain Medicines | FDA.

No. Opioids pose a risk to all patients. Anyone taking prescription opioids is at risk for unintentional overdose or death and can become addicted. From 1999 to 2021, nearly 280,000 people died from overdoses involving 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 opioid use disorder.^2,3,4

In addition to the serious risks of opioid use disorder and overdose, the use of prescription opioids can have several side effects, even when taken as directed. Review these with your doctor so you know what you may expect:

• Tolerance—needing to take more of the medication over time for the same pain relief
• Physical dependence—experiencing symptoms of withdrawal when the medication is stopped
• Increased sensitivity to pain
• Constipation
• Nausea and vomiting
• Dry mouth
• Sleepiness
• Dizziness
• Confusion
• Low levels of testosterone that can result in lower sex drive, energy, and strength
• Itching
• 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.

Talk to your doctor about any other medications you are using. Work out a plan to call your doctor if you continue to experience pain. Also ask about the serious side effects of opioids (like excessive sleepiness or craving more of the medication) so you and your family know when to call a doctor or call 911.

Anyone who uses opioids can experience an overdose, but certain factors may increase risk including but not limited to:

• Having a history of overdose or a substance use disorder
• Having sleep apnea or other sleep-disordered breathing
• Taking higher dosages of opioids (e.g., ≥50 MME/day)
• Returning to a high dose after losing tolerance (e.g., patients undergoing tapering or recently released from prison)
• Taking benzodiazepines with opioids
• Having kidney or liver failure
• Being 65 years and older

The CDC Clinical Practice Guideline for Prescribing Opioids for Pain (2022 Clinical Practice Guideline) is voluntary guidance for clinicians that was created to help inform decision making. The recommendations were developed for clinicians who provide pain care — including those prescribing opioids — for adults with short- and long-term pain. The 2022 Clinical Practice Guideline was developed because CDC recognized that clinicians need current recommendations for prescribing opioids to improve pain management and patient safety. The 2022 Clinical Practice Guideline aims to help clinicians and patients work together to ensure the safest and most effective pain care can be provided.

This publication updates and replaces the CDC Guideline for Prescribing Opioids for Chronic Pain released in 2016.

The CDC Clinical Practice Guideline for Prescribing Opioids for Pain–United States, 2022 updates and replaces the CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. The new guideline includes recommendations on determining whether or not to initiate opioids for pain, selecting opioids and determining opioid dosages, deciding duration of initial opioid prescription and conducting follow-up, and assessing risk and addressing potential harms of opioid use.

The 2022 Clinical Practice Guideline does not support rapid tapering, patient abandonment, or abrupt discontinuation of opioids. A critical piece of the 2022 Clinical Practice Guideline is the incorporation of new guidance to help clinicians and patients carefully weigh the benefits and risks of tapering opioids or continuing opioids. Specifically, it advises against abrupt discontinuation as well as rapid dosage reductions of opioids. It also recommends that tapers be used when treatment is discontinued after opioids have been used continuously for more than a few days, to prevent withdrawal symptoms. Expanded practical tips on tapers are outlined to help clinicians work with patients already receiving opioids in determining whether to taper medications and how to taper them if the decision is made to do so.

The 2022 Clinical Practice Guideline is flexible and encourages individualized care. It encourages clinicians to create or update a pain treatment plan with their patients, based on the patient’s individual needs and circumstances. You and your doctor should work together to determine your treatment goals and path forward.

No. This voluntary guideline provides recommendations only and is meant to support patients and clinicians in making decisions about pain treatment that are safe, effective, and right for the patient. These recommendations are for patients 18 and older in outpatient settings with acute pain, subacute pain, or chronic pain.

These recommendations do not apply to:

• Pain management related to sickle cell disease
• Cancer-related pain treatment
• Palliative care
• End-of-life care

These web pages will help you learn more about prescription opioids:

• Opioid Basics
• Commonly Used Terms
• Helpful Materials for Patients
• Rx Awareness Campaign