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CONVERSATION STARTER

Talking With Patients About Nonopioid Therapies for Pain Management

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Nonopioid therapies may provide safer and more effective pain management than opioids. Whenever it’s appropriate, maximize the use of non-drug therapies (ice, heat, elevation, rest) and nonopioid medication therapies (topical or oral nonsteroidal anti-inflammatory drugs, acetaminophen). These treatments do not have the same risks as opioids and align with the 2022 CDC Clinical Practice Guideline recommendation to focus on pain management treatments that offer the greatest benefits with the fewest risks.

1,2Clinicians can help patients consider nonopioid therapies by having open and collaborative conversations. Clear communication and active patient participation are key to building a trusting relationship and helping patients explore nonopioid therapies to manage their pain.

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The following tips can help engage patients in conversations about nonopioid therapies.

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Create an environment where patients can collaborate with you to explore nonopioid therapies and make informed decisions that fit their individual needs and preferences.
For example:

• “In addition to opioids, there are a lot of nonopioid therapies available that can effectively address pain with less risk. I think it’s important for us to explore these options together.”
• “After carefully assessing your condition and reviewing your treatment progress, I think it’s worth considering nonopioid therapies. These options can provide effective pain relief with less risk. Let’s talk about these options and see if they match your goals for pain treatment and overall well-being.”

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Involve patients in making decisions and setting goals.

For example:

• “Your input and preferences matter. Let’s talk about your treatment goals and how nonopioid therapies might help. With your input, we can create a plan that suits your lifestyle and maximizes the benefits of nonopioid treatments.”
• “I believe in working together to achieve your pain treatment goals. Your input is important to determine the best nonopioid therapies for you. We will look at your preferences, daily activities, and anything that could make treatment difficult and develop a full plan that addresses your pain while ensuring you are safe and comfortable.”
• Address patient concerns or misconceptions about nonopioid therapies and encourage open conversation. For example, “I understand you may have doubts about nonopioid therapies. Let’s talk through any concerns, and I’ll give you some information to help you make your decision.”

Ask the patient for their questions, opinions, and other input to involve them in the decision-making process.

For example:

• “What are your thoughts on using some nonopioid therapies in your pain treatment? I value your input and want to make sure we consider your preferences and goals throughout the treatment process.”
• “Can you share your thoughts on continuing with the current approach versus exploring nonopioid options?”

1. Skelly A, Chou R, Dettori J, et al. (2020). Noninvasive nonpharmacological treatment for chronic pain: a systematic review update. Comparative effectiveness review no. 227. Rockville, MD: Agency for Healthcare Research and Quality.
2. Chou R, Wagner J, Ahmed A, et al. (2020). Treatments for acute pain: a systematic review. Comparative effectiveness review no. 240. Rockville, MD: Agency for Healthcare Research and Quality.

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Want to know more? Check out the following links for more information on related topics.

• CDC’s Clinical Practice Guideline for Prescribing Opioids for Pain
• Nonopioid Therapies for Pain Management
• Nonopioid Therapies
• Safely and Effectively Managing Pain Without Opioids

www.cdc.gov/opioids