Significant Reduction in ER Opioid Prescriptions for Low Back Pain, Study Reveals

A new study shows a remarkable decrease in opioid prescriptions for low back pain in emergency rooms, reflecting improved prescribing practices and growing awareness of opioid risks.
A recent study highlights a marked decline in the use of opioid medications prescribed in emergency rooms (ER) for patients suffering from low back pain. The research, published in the Annals of Emergency Medicine, shows that between 2016 and 2022, the rate of opioid prescriptions in ER visits for low back pain was reduced by more than half. Specifically, in 2016, nearly 32% of these visits resulted in opioid prescriptions, but by 2022, this figure had dropped to just over 13%.
This trend indicates a positive shift in clinical practice, likely driven by increased awareness of the opioid epidemic and evolving evidence supporting alternative pain management strategies. Lead researcher Dr. Howard Kim, an emergency physician from Northwestern University Feinberg School of Medicine, commented that physicians are increasingly responding to evidence and changing their prescribing habits.
The analysis was based on nearly 53 million ER visits across the United States for low back pain during this period. Patients reported significant pain levels, with an average score exceeding seven out of ten, and spent an average of four hours in the ER, awaiting care.
In terms of preferred treatments, non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, have become the principal choice for managing low back pain, being administered in approximately 29% of cases. Meanwhile, the administration of opioids has decreased from 35% in 2016 to below 25% in 2020.
Despite progress, some areas still require improvement. The study highlights that over one-third of patients still received X-rays, with the rate remaining consistent from 2015 to 2022 and reaching a peak of 44% in 2021. Researchers emphasize that reducing unnecessary imaging is essential, but complex, due to various factors influencing clinicians' decisions.
Overall, the findings suggest that emergency physicians are increasingly adhering to guidelines that recommend conservative management for low back pain, minimizing opioid use, and encouraging appropriate diagnostic procedures.
Source: https://medicalxpress.com/news/2025-07-er-opioid-prescriptions-pain.html
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