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Prescription pillsFederal regulators from the U.S. Centers for Disease Control and Prevention announced on Tuesday that doctors must be more cautious when prescribing painkillers. In an attempt to decrease the epidemic of deaths related to narcotics overdose, the CDC encouraged doctors to recommend to their patients physical therapy and over-the-counter medications before prescribing opioids to treat chronic pain.

The CDC is now urging physicians to use non-narcotic drugs in most cases, with the exception of cancer treatment. For patients undergoing palliative and end-of-life care, they recommend only issuing the lowest effective dose of opioids. All other cases, they say, should first be treated without the use of narcotics.

“Overprescribing opioids — largely for chronic pain — is a key driver of America’s drug-overdose epidemic,” said CDC Director Tom Frieden as he made his announcement. “The guideline will give physicians and patients the information they need to make more informed decisions about treatment.”

Critics of these strict guidelines are concerned that this will block patient access to medications. The American Medical Association fears that patients will be directed toward pain treatments that are not covered by insurance. Those in favor of the guidelines believe that this is a positive first step to decreasing widespread narcotics abuse and addiction.

A recent report indicates that over 1.5 billion people worldwide suffer from chronic pain. Since 1999, sales of opium-based painkillers have quadrupled, and in 2014, doctors wrote almost 200 million prescriptions for these drugs in the United States. Meanwhile, nearly 19,000 people have died as a result of opioid-related drug use.

“Used appropriately, opioids are an important tool in treating pain,” stated Dr. Asokumar Buvanendran of the Rush Pain Center in Chicago. “But there are very many safe, non-pharmacological and non-opioid pharmacalogical therapies proven to be as or more effective than opioids that don’t carry the risk of dependence.”

Dr. Buvanendran encourages physicians to educate themselves about the alternatives, such as spinal cord stimulation and epidural injections.