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Who Prescribes Pain Medications: Prescription Guidelines

Last Updated: March 24, 2024

Authored by Roger Weiss, MD

Reviewed by David Levin

Painkillers should be used for medical purposes only for relieving different types of pain from cancer, injury, surgery, headache, toothache, arthritis, menstrual cramps, or an illness. It may be gotten in many potencies and forms by prescription or as an OTC medication. Health care providers follow guidelines for prescribing pain medications to ensure that the patients take their medications correctly and safely. The risk of addiction and tolerance is minimized if the painkillers are taken as prescribed.

Doctors Who Prescribe Pain Medications

Only a doctor should prescribe pain medications for patients. The healthcare provider should also tell the patient about the possible side effects and accurate dosing of it. When prescribing narcotic painkillers, both the doctor and the patient should sign a pain management agreement. This agreement is established to ensure that the patient takes the pain management medication according to the recommendations of the doctor. How to find a doctor to prescribe pain meds? Go to the nearest clinic, or search on the Internet if one wants reasonably verify the doctor’s experience and the authority to give prescriptions for pain medications. Many clinics, especially private ones, provide detailed information on the doctor’s qualifications and experience.

What Doctors Are Allowed To Prescribe Analgesics?

  • Can chiropractors prescribe pain medications, such as opioids? No, chiropractic doctors are not licensed for prescribing it.
  • Do chiropractors prescribe pain meds for a minor pain? Yes, chiropractors can prescribe medications such as NSAIDs and acetaminophen for minor spasm and ache.
  • Can dentists prescribe pain medications? A dentist may prescribe some such as acetaminophen and ibuprofen after tooth extraction. It is not allowed for a dentist to prescribe narcotic pain meds, but in certain circumstances as after a dental procedure, the dentist may prescribe it at a minimal concentration as these medications are effective and safe at low doses.
  • Can a psychiatrist prescribe pain medications? A psychiatrist may prescribe opioids at a minimal concentration for cases that have not responded to the non-opioids.
  • Do orthopedic doctors prescribe pain medications? Yes, orthopedists are the doctors who prescribe pain meds such as opiates in recommended doses after orthopedic surgery.
  • Can physical therapists prescribe pain meds? The physical therapist is not allowed to prescribe these drugs.

Doctors Who Prescribe Pain Medication Online

Sometimes, the patient with severe pain may need consultation from online doctors for pain medication. Doctors who prescribe pain medication online make it easier also for patients with disabilities to get their medications. Doctors who prescribe pain meds online send the electronic prescription to a local hospital or pharmacy. There are no exceptions for prescribing painkillers online because of the more restrictive considerations by law for prescribing analgesics via the Internet. The online doctors who write prescriptions for pain meds should follow these regulations to decrease the chance of addiction that may be caused by misusing it. However, the risk of opioids abuse increases with doctors who prescribe pain medication easily.

How to find a doctor who will prescribe pain medications online? The most appropriate way is to arrange with the current doctor while real meeting for getting subsequent prescriptions via the Internet instead of frequent meetings.

Guidelines For Pain Medications

The Centers for Disease Control and Prevention (CDC) provides guidelines and recommendations for physicians for ensuring safer and effective treatment with the appropriate opioids. These guidelines are implemented for taking painkillers safely to diminish the misuse of narcotic pain meds. The guidelines also help in improving the communication between healthcare providers and patients about the benefits of using opioids as prescribed and also about the possible adverse reactions that may occur after using these medications. The CDC guidelines for prescribing opioids are:

  • Use of the lowest effective dose of banned list of opioids is one of the vital guidelines for patient safety to avoid the risk of misuse and side effects of painkillers. The banned painkillers list includes fentanyl, oxymorphone, methadone, oxycodone, and morphine. The health care provider may prescribe one of this list for patients suffering from long term pain, but some addicts may get it illegally and misusing it. As a result it is prohibited by the law for decreasing its dangerous side effects.
  • A doctor must evaluate the pros and cons of opioids with patients after one to four weeks of the treatment. The further use should be evaluated frequently every 3 months for continued treatment.
  • The healthcare provider should prescribe immediate-release opioids when starting the treatment instead of long acting pain medication.
  • The use of non-pharmacological treatments such as physical and behavioral treatments is preferred as a first-choice treatment.
  • Taking alternatives to pain medication, such as herbal painkillers, may be preferred in some cases, but still should be agreed with the doctor. Otherwise, non-opioids such as acetaminophen and non-steroidal anti-inflammatory drugs are recommended.
  • The doctors should establish realistic treatment goals before starting treatment with opioids. A doctor must discuss with patients the benefits and risks before starting and during treatment with opioids, and set a plan for continuing use of treatment if the benefits exceed the risks. However, the treatment with opioids may discontinue if the benefits do not outweigh the drug harm.
  • The healthcare providers must set strategies for mitigating the risk of opioids adverse reactions and should evaluate risk factors for harms that may appear. The risk of opioids overdose increases with the presence of a history opioids overdose, coadministration with benzodiazepine, and taking high doses of opioids, which requires the use of naloxone as an antidote for treating opioids overdose.
  • The doctor should assign an opioid treatment agreement with each patient before starting treatment.
  • The doctor should ask the patient to submit a urine drug testing annually before starting the treatment with opioids and also asked for submitting periodic painkillers pills counts.
  • The healthcare providers should use periodically an electronic database called prescription drug monitoring program (PDMP) during treatment for monitoring opioids and determining the actual cause of overdose.

guidelines for prescribing pain medications

Non-opioids are the first line for treating chronic pain safely as in cancer and at the end of life. The CDC guidelines for prescribing non-opioid painkillers include:

  • Using acetaminophen as a first-line non-opioid painkiller and also taking NSAIDs selective inhibitor of cyclooxygenase 2 as a first-line treatment with less gastric toxicity.
  • Taking pregabalin as a first-line treatment for relieving neuropathic pain and tricyclic antidepressants as a first line medication for treating psychological pain, headache, and fibromyalgia.
  • The patient who suffers from low back pain may need self- care and non-pharmacological treatment such as exercise and behavioral treatment and is advised to remain active with no bed rest. Acetaminophen and NSAIDs are the first lines lower back pain medication.
  • Acute episodes of migraine may be treated with acetaminophen and aspirin.
  • Osteoarthritis can be treated by non-pharmacological therapy with exercise and weight loss. Acetaminophen and NSAIDs are the first lines of treating osteoarthritis.

Getting Pain Medications From A Doctor

It’s hard to develop the addiction to opioids if one uses them as prescribed. Some abusers are getting high off painkillers by misusing them. There are genetic, environmental, and psychological factors that have a major role in the addictive person. The persons that have a high risk of painkiller addiction are young adults, the ones who live under stress, who are in contact with other abusers, and the heavy smokers.

The most popular signs of painkillers addiction include irregular sleep patterns, taking opioid analgesics not as prescribed or taking it without feeling pain, manic depression, seeking the opioid prescription from various healthcare providers to have a backup of these medications, and making a bad decision.

What To Say To A Doctor?

How to ask a doctor for pain medications? A doctor may prescribe a certain type of painkillers for the patient according to the severity of pain. A patient must tell the healthcare provider about current non-opioid and opioid medications and non-pharmacological treatment. The patient must tell the doctor about the exact place of pain or spasm in the body, its duration, and its frequency to help in knowing the actual cause of it.

How To Ask A Doctor For Stronger Analgesics?

Pain medication doctors can give the patient a prescription for opioids in the clinic and also online. It is necessary to talk with a doctor about the opioids treatment option to safely use analgesics. How to ask a doctor for stronger pain meds, if previously prescribed don’t work anymore? Stronger painkillers like opioids are ones of the most commonly abused drugs, asking a doctor for prescribing these medications do not target their addiction but have a beneficial outcome when used as prescribed. Careful monitoring of stronger analgesics decreases the risk of their addiction and abuse.

Getting Analgesics From Urgent Care

Before prescribing analgesics at ER, the doctor should ask about the patient’s age, medication history, check if the patient is red flagged for pain meds, and the nature of pain. ER doctor prescribes pain medications according to the patient’s condition. The urgent care doctor cannot prescribe opioid analgesics for a patient even if one is suffering from severe back and abdominal pain, as there is no monitoring of these medications when going home. However, most ER doctors can prescribe non-opioids. According to a study published in the Journal of International Medical Research, a single dose of combined acetaminophen and ibuprofen reduces acute extremity pain as opioids.

is it possible to get analgesics from urgent care

Getting Painkillers Online

In the case of long term pain, the doctor can prescribe opioids for a patient for pain relief, and the patient can buy pain meds online legally from internet pharmacies by a prescription. Some patients and simply recreational users use online services illegally, leading to an increase in the number of painkiller abusers. As a result, the availability of prescription opioids via online pharmacy decreased because of increased regulations against Internet pharmacies to decrease painkiller addiction.

Getting Appropriate Painkillers

When getting the prescription for analgesics, the patient should tell the doctor honestly about medication history and the nature of pain. The healthcare provider may prescribe appropriate opioid according to the CDC guidelines to avoid the risk of abuse. The patients who are suffering from pain may also be addicted to these medications when used for a long period of time. The addicted person should seek a rehabilitation facility as soon as possible to accelerate the recovery process. Treating the addiction to painkillers successfully requires active communication between the patient and healthcare provider.

Page Sources

  1. Rebecca L. Haffajee, Anupam B. Jena, Scott G. Weiner. Mandatory Use of Prescription Drug Monitoring Programs. 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465450/
  2. Chang AK, Bijur PE, Esses D, Barnaby DP, Baer J. Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency Department: A Randomized Clinical Trial.. 2017. https://www.ncbi.nlm.nih.gov/pubmed/29114833
  3. Edward W. Boyer, James D. Wines, Jr. Impact of Internet Pharmacy Regulation on Opioid Analgesic Availability. 2008. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2575390/

Published on: September 25th, 2019

Updated on: March 24th, 2024

About Author

Roger Weiss, MD

Dr. Roger Weiss is a practicing mental health specialist at the hospital. Dr. Weiss combines his clinical practice and medical writing career since 2009. Apart from these activities, Dr. Weiss also delivers lectures for youth, former addicts, and everyone interested in topics such as substance abuse and treatment.

Medically Reviewed by

David Levin


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  • Brian Combs
    I’m begging for help my pain doctor sent me in for many mri and sent me to 3 surgeons they all said no surgery at all just keep me on a routine meds now I found out he is out of service from osu medical board I was on many different meds but if I can go to percet 10mg 4times a day

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