With an estimated 5 million Americans battling opioid use disorder—resulting in tens of thousands of deaths each year—a new study by the University of Texas at Arlington examines how updated Centers for Disease Control and Prevention guidelines can help nurse practitioners reduce misuse and protect patients.
In 2023, approximately 105,000 people died from drug overdoses—nearly 80% of which involved opioids, according to the CDC. The UT Arlington study, recently published in The Nurse Practitioner, examines how the CDC’s revised guidelines in 2022 provide clearer, more practical direction for nurse practitioners, who often receive limited formal training in pain management compared to other medical conditions.
“We, like most medical providers, don’t get a lot of training on how to prescribe opioids and treat pain,” said Rhonda Winegar, UTA assistant professor in the family nurse practitioner graduate program and lead author of the study. “These guidelines walk providers through the process step by step—helping them prescribe responsibly, monitor patients closely and avoid unintentionally contributing to the epidemic.”
The updated guidance emphasizes individualized care, clinical judgment and ongoing reassessment. The guidelines focus on four key areas. While the principles may seem straightforward, the study notes that they are often applied inconsistently in practice—particularly in fast-paced primary care settings where nurse practitioners shoulder much of the responsibility for pain management.
The four areas include:
- Determining whether to prescribe opioids
- Selecting the appropriate opioid and dosage
- Establishing appropriate duration of use and follow-up
- Assessing risks and implementing mitigation strategies
“Constant evaluation and follow-up are key,” Dr. Winegar said. “It’s also important to consider non-pharmacologic options like massage, yoga, acupuncture, water therapy and heating pads.”
She said incorporating these approaches early can reduce reliance on opioids altogether, especially for patients managing chronic pain.
By following the CDC’s framework, Winegar said, nurse practitioners can better navigate the risks associated with high doses and prolonged use, which can increase the likelihood of dependence and addiction.
“These guidelines help ensure that nurse practitioners are part of the solution, not the problem,” she said.
Co-authors on the study included UTA nursing professors Zhaoli Liu and Tara Martin. Winegar and Dr. Liu are practicing nurse practitioners.
More information
Rhonda Winegar et al, Updated opioid prescribing guidelines, The Nurse Practitioner (2025). DOI: 10.1097/01.npr.0000000000000373
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