Physicians in the U.S. write more than 250 million prescriptions a year for opioid painkillers — and that’s not including all the painkiller prescriptions written for patients with cancer or acute/chronic pain. That’s enough for every adult in the U.S. to have their own bottle of pills. Meanwhile, every day more than 40 Americans die after overdosing on opioids. That’s why the Centers for Disease Control and Prevention is urging primary care physicians — who prescribe about half of all opioids — to rethink how generous they are with their prescriptions.

A new set of guidelines for physicians [PDF] released this week by the CDC provides recommendations for primary care providers on responsible ways to treat chronic pain — pain that lasts longer than three months, or longer than it takes for tissue to heal — with opioids.

The CDC acknowledges that opioids can be integral to managing pain, but contends that the benefits of painkiller use should be balanced against the associated risks, including dependency and overdose.

According to the CDC, more than 165,000 Americans died from overdosing on opioid pain meds between 1999 and 2014. And while recent advances in treating diseases like heart disease and cancer have caused significant decreases in those common killers, “the death rate associated with opioid pain medication has increased markedly” and “Sales of opioid pain medication have increased in parallel with opioid-related overdose deaths.”

For every overdose death, there are many more people being hospitalized for using opioids. In 2011 alone, narcotic painkiller use accounted for more than 420,000 emergency room visits.

The guidelines, which are only suggestions for physicians and not legally binding regulations, try to aid doctors in determining if and when they should use opioids to treat chronic pain. It provides specific information on medication selection, dosage, duration, along with information how to assess a patient’s progress and when, if needed, to discontinue medication.

In general, the CDC is recommending that non-opioid therapy be used to treat patients who fall outside the umbrella of active cancer treatments, palliative care, and end-of-life care. If physicians do prescribe opioids, the CDC suggests prescribing the lowest possible effective dosage.

“Doctors want to help patients in pain and are worried about opioid misuse and addiction,” said Dr. Debra Houry, director of CDC’s National Center for Injury Prevention and Control. “This guideline will help equip them with the knowledge and guidance needed to talk with their patients about how to manage pain in the safest, most effective manner.”

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

In addition to the guidance for physicians, CDC has information on its website for patients to better understand opioids and their associated risks.

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