What to expect from your doctor

The Centers for Disease Control and Prevention (CDC) provides guidance to physicians for safe prescribing of opioid medications. Following the CDC's recommendations, you should expect your doctor to:

• Prescribe the lowest effective dose, for the shortest period needed, when treating acute pain. In most cases, acute pain — such as pain that follows surgery or a bone fracture — is not severe enough to require opioids for more than three days.
• Avoid or delay prescribing opioids for chronic pain. These medications are not often safe or effective for chronic pain unrelated to cancer or cancer treatments. Your doctor should help you evaluate many other therapies — including nonpharmacological treatments and nonopioid medications — before considering a trial of opioids.
• Work with you to establish realistic treatment goals. Your doctor should help you determine how much pain relief you need in order to gain improvements in your ability to function and quality of life. There's no cure for chronic pain, even with drugs as powerful as opioids, and there are risks associated with all pain medications. You and your doctor should be partners in maximizing your enjoyment of life while minimizing medication-related health risks.

• Ask you to sign an opioid therapy agreement before you start a long-term course of opioid medications. Typically, these agreements clearly state your responsibilities while using opioid medications. You'll agree to use opioids only as prescribed and to obtain painkillers from only one physician and one pharmacy. You'll acknowledge that you won't receive additional medication until your current prescription runs out, even if your medication is lost or stolen.

  You may be asked to submit to periodic urine tests and pill counts. You'll agree to maintain all aspects of your treatment plan — such as physical therapy or behavioral medicine — and to keep all scheduled follow-up appointments. Violation of any of these terms may prompt termination of opioid therapy.

• Schedule regular checkups while you're taking opioids. Expect your doctor to require a follow-up appointment one to four weeks after you start opioid therapy, to evaluate the benefits and risks of these medications for you so far. If you continue taking opioids, your doctor will need to continue seeing you frequently — either with every prescription refill or every three months — for as long as you use these drugs. These visits may include urine tests.
• Help you minimize withdrawal when you stop opioids. If you've taken opioids for chronic pain and determine it's time to stop, your doctor should help you slowly and safely taper off these drugs to avoid potentially severe side effects.