Emergency rooms are handing out significantly fewer opioid prescriptions to people experiencing lower back pain. Researchers reported in the Annals of Emergency Medicine on July 12 that the rate of opioid prescriptions for back pain in ERs dropped by more than half between 2016 and 2022. Dramatic Decline in Opioid Prescribing Just a few years ago, in 2016, almost one out of every three visits to the ER for back pain ended with a prescription for opioid painkillers. But by 2022, that number had fallen dramatically to just over one in ten visits. This big drop means that doctors are learning from the available information and changing the way they practice medicine, especially as more people become aware of the widespread problems caused by opioid addiction. It's a positive sign that medical professionals are actively working to curb the opioid crisis. Understanding the Study and Patient Experience To figure this out, researchers looked at records from nearly 53 million ER visits for low back pain that happened between 2016 and 2022. These records were gathered by a national health statistics centre. The study found that when people went to the ER for back pain, they were usually in a lot of discomfort, rating their pain at more than 7 out of 10. On average, they had to wait about 37 minutes before a doctor saw them and spent around four hours in the emergency room getting treatment. Why Opioid Usage Is Risky For PatientsA 2023 study even found that opioids may not be as effective for back pain. Published in the JAMA network, a 2023 study conducted a trial on those who were experiencing back pain. The trial involved 347 adults who had been experiencing pain for up to 12 weeks. Everyone in the study received standard care, which included reassurance, advice to avoid bed rest, and encouragement to stay active. Half of the participants also received a combination of oxycodone and naloxone (an opioid), while the other half received a placebo (a dummy pill).The study also revealed that while side effects were similar for both groups, there was a significant difference in the risk of opioid misuse. One year later, 20% of the participants who took opioids were at risk of misusing them, compared to only 10% of those who received the placebo. This suggests that even for short-term pain relief, opioids carry a greater risk of future misuse.NSAIDs Emerge as Preferred Treatment Now, when you go to the ER with low back pain, nonsteroidal anti-inflammatory drugs, often called NSAIDs (like ibuprofen), are the most common painkillers prescribed. They're given to almost 29% of patients. It's not just about prescriptions either; fewer patients are actually given opioids while they are being treated in the ER. That number went down from 35% of cases in 2016 to less than 25% by 2020, showing a clear shift away from immediate opioid use during emergency care for back pain.Next Issues People Must Tackle Even though there's good progress with reducing opioids, ER doctors still have some areas where they could improve how they treat back pain. For example, many patients with back pain are still getting X-rays that they don't really need. In 2022, about 37% of patients had an X-ray, which is pretty much the same as in 2015. In fact, in 2021, almost 44% of cases involved an X-ray, which was the highest rate. It's tough to get this number down because deciding whether to order an X-ray can be complicated and depends on what both the doctor and the patient think is best.