The Opioid Crisis: A Call for Change

The ongoing opioid crisis is forcing healthcare professionals to rethink pain management, especially in hospitals where patients often experience acute pain. Increasing evidence indicates that non-opioid alternatives—such as acetaminophen, NSAIDs, gabapentin, and certain antidepressants—could effectively alleviate pain while minimizing opioid use in hospitalized patients.

Groundbreaking Research Presentation

Dr. Angel Goenawan, a hospitalist at Bayhealth in Delaware, recently unveiled a meta-analysis at the American College of Physicians' Internal Medicine Meeting 2025. This research examined opioid-sparing regimens across eight randomized clinical trials—two targeting non-surgical patients and six focusing on surgical cases.

Rethinking Pain Management Strategies

Dr. Goenawan emphasized the need for exploring alternatives to opioids. With the opioid epidemic claiming countless lives, the medical community must find effective ways to manage pain without adding to the crisis.

Insights from the Meta-Analysis

This comprehensive review revealed that patients utilizing non-opioid regimens reported better pain control and a significant reduction in opioid consumption compared to those on traditional opioid therapies. Notably, results showed a much lower total opioid dosage among patients using alternatives.

Challenges and Cautions in Non-Opioid Use

Despite promising findings, many clinicians remain cautious, particularly about the use of NSAIDs in sicker patients who might be at risk of acute kidney injury. Dr. Goenawan pointed out the importance of individualized pain management protocols, which would consider each patient's condition before deciding on treatment.

Looking Ahead: More Research Needed

Dr. Goenawan advocates for more extensive research with larger, more diverse patient populations to confirm and expand upon their findings, so that effective, non-opioid pain management strategies can be tailored to various medical contexts.

Signs of Change in the Medical Community

There’s a growing awareness among physicians regarding opioid prescribing patterns. Following the CDC's initiative in 2016 aimed at reducing opioid dependency, there has been a noticeable decline in opioid prescriptions. While progress has been made, the struggle against opioid use disorder remains real and requires ongoing commitment from healthcare professionals.