The Changing Prescriber Habits of Opioids and How It Impacts Patient Care

Over the last two decades, opioid prescribing in the United States has undergone a dramatic transformation. The opioid epidemic prompted federal and state agencies to tighten oversight, creating new challenges for prescribers, patients, and community pharmacies alike.

From Widespread Prescriptions to Stricter Oversight

Historically, opioids were a primary tool for managing both acute and chronic pain. However, rising addiction and overdose rates prompted the Drug Enforcement Administration (DEA) and wholesalers to implement rigorous monitoring of prescriber and dispenser patterns, flagging potential diversion or unsafe practices. States have enacted additional limits, such as Tennessee’s requirement to split a 30-day prescription into two fills for acute pain. These measures aim to reduce leftover pills in medicine cabinets, lowering the risk of misuse.

Impact on Patients and Pharmacies

While necessary, these restrictions can leave patients with more limited access to effective pain management. Pharmacists find themselves at the center of this balancing act, ensuring compliance while helping patients navigate new prescribing rules.

With roughly one in four American adults experiencing chronic pain and nearly one in twelve suffering from pain that significantly limits daily activity (CDC, 2024), the demand for effective, accessible pain solutions has never been greater. This shift has sparked interest in safe, non-opioid alternatives—and community pharmacies are uniquely positioned to guide patients toward options that reduce reliance on controlled substances.

Non-Opioid Alternatives on the Rise

Topical analgesics and other non-opioid therapies are increasingly popular. These products provide localized relief, reduce systemic exposure, and can be recommended without the regulatory burden of controlled substances.

Products like Little Miracle Pain Spray offer rapid, targeted pain relief, giving patients an accessible alternative to oral medications. Similarly, OrthoFreeze, designed for musculoskeletal discomfort, has shown efficacy in managing chronic joint and muscle pain.

For CBD-based alternatives, PharmaCanna stands out: founded in 2016 by a compounding-pharmacy owner, PharmaCanna has become a trusted brand serving thousands of pharmacies and licensed healthcare providers across the country. Its mission is to offer high-quality, third-party tested, hemp-derived CBD products developed specifically for the needs of community pharmacy.

By offering these solutions, pharmacies can position themselves as trusted healthcare destinations helping patients solve pain-management challenges while promoting safety.

Non-oral treatments also help patients avoid side-effects often associated with systemic opioid therapy most notably constipation, a persistent issue caused by reduced gastrointestinal motility. By providing effective relief without these complications, topical and alternative therapies reinforce the pharmacy’s role in safe, responsible pain management.

The Evolving Role of the Pharmacist

Pharmacists are no longer just dispensers; they are educators, counselors, and advocates for responsible pain care. They can:

• Assess patients’ needs and identify suitable non-opioid options.
  
  
• Educate on topical analgesics, CBD-derived products, and other alternatives.
  
  
• Monitor outcomes and collaborate with prescribers for optimal therapy.
  

This expanded role reinforces the pharmacy’s position as a vital healthcare hub in every community.

Opportunities for Community Pharmacies

The changing opioid landscape also creates opportunities to engage patients and diversify revenue:

• Increase patient engagement: Personalized solutions foster loyalty.
  
  
• Offer safer alternatives: Reduce opioid reliance with proven OTC and CBD options.
  
  
• Drive front-end profitability: High-quality topical and CBD products carry average pharmacy margins of 40-60%, far exceeding typical prescription reimbursement rates (Forbes, 2023).
  
  
• Demonstrate leadership: Position the pharmacy as a forward-thinking healthcare destination.
  

Broader U.S. CBD sales have risen from $108 million in 2014 to nearly $1.9 billion in 2022, reflecting strong consumer demand for non-opioid pain solutions and highlighting a major growth opportunity for independent pharmacies.

When choosing vendor partners to stock in your analgesic aisle, look for companies that use premium ingredients and are strategically invested in the success of community pharmacy. Providing educational tools—like point-of-sale signage, bag inserts, product testers, and co-branded materials—can help guide customers and strengthen buying confidence.

Looking Ahead: The Next Frontier in Pain Care and Policy

As prescriber habits evolve, pharmacists must remain informed and proactive but there’s another conversation on the horizon that could redefine pain management entirely: the potential federal reclassification or legalization of THC-based medications and products.

If cannabis-derived products are federally legalized or reclassified under the Controlled Substances Act, community pharmacies with their existing DEA licensure, prescription controls, and clinical expertise are natural candidates to serve as the most responsible retail access points.
 Unlike dispensaries, pharmacies already operate within a robust framework of documentation, verification, and counseling all vital for the safe distribution of any controlled therapeutic substance.

Advocating for this future role is more than an economic opportunity; it’s a professional imperative. Independent pharmacies could collectively represent a multibillion-dollar industry channel if permitted to dispense THC-based medications within regulated parameters. But with that opportunity comes the responsibility to maintain integrity, education, and patient safety as top priorities.

By staying engaged in advocacy efforts and supporting legislation that recognizes pharmacy’s role in controlled substance stewardship, the profession can help shape a safer, more accountable framework for future cannabinoid therapeutics.

While the shift in opioid prescribing has presented undeniable challenges, it has also opened doors for innovation in pain care and professional advocacy. Pharmacies that embrace non-opioid alternatives, partner with reputable suppliers like PharmaCanna, Little Miracle Pain Spray, and OrthoFreeze, and engage in forward-thinking discussions about the future of cannabinoid therapeutics will not only meet their patients’ evolving needs, but also lead the next era of responsible pain management in America.

Author: Kris Rhea, MBA